Short-Course Antiretroviral Therapy in Primary HIV Infection

The value of beginning antiretroviral therapy in primary HIV-1 infection is unclear. In this trial, 366 patients with primary HIV infection were randomly assigned to one of three treatment approaches. A modest effect of 48 weeks of early ART was found. Although the use of highly active antiretroviral therapy (ART) in human immunodeficiency virus (HIV) disease reduces morbidity and mortality, 1 – 3 the role of ART in the management of primary HIV infection remains controversial. 4 – 6 Immunologic damage after HIV acquisition occurs rapidly and is not wholly reversible by later ART. 7 – 9 Observational studies have suggested that a short course of ART during primary HIV infection may preserve immune function, 10 , 11 decrease viral evolution, 12 and limit the viral reservoir. 13 – 15 Two randomized, controlled trials — the AIDS Clinical Trials Group Setpoint Study and the Primo-SHM trial, involving 130 and 115 participants, respectively . . .