PLoS Medicine (Jan 2012)

No treatment versus 24 or 60 weeks of antiretroviral treatment during primary HIV infection: the randomized Primo-SHM trial.

  • Marlous L Grijsen,
  • Radjin Steingrover,
  • Ferdinand W N M Wit,
  • Suzanne Jurriaans,
  • Annelies Verbon,
  • Kees Brinkman,
  • Marchina E van der Ende,
  • Robin Soetekouw,
  • Frank de Wolf,
  • Joep M A Lange,
  • Hanneke Schuitemaker,
  • Jan M Prins,
  • Primo-SHM Study Group

DOI
https://doi.org/10.1371/journal.pmed.1001196
Journal volume & issue
Vol. 9, no. 3
p. e1001196

Abstract

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BackgroundThe objective of this study was to assess the benefit of temporary combination antiretroviral therapy (cART) during primary HIV infection (PHI).Methods and findingsAdult patients with laboratory evidence of PHI were recruited in 13 HIV treatment centers in the Netherlands and randomly assigned to receive no treatment or 24 or 60 wk of cART (allocation in a 1∶1∶1 ratio); if therapy was clinically indicated, participants were randomized over the two treatment arms (allocation in a 1∶1 ratio). Primary end points were (1) viral set point, defined as the plasma viral load 36 wk after randomization in the no treatment arm and 36 wk after treatment interruption in the treatment arms, and (2) the total time that patients were off therapy, defined as the time between randomization and start of cART in the no treatment arm, and the time between treatment interruption and restart of cART in the treatment arms. cART was (re)started in case of confirmed CD4 cell count ConclusionsIn this trial, temporary cART during PHI was found to transiently lower the viral set point and defer the restart of cART during chronic HIV infection.