HIV treatment was revolutionized in the1990s with the development of the HIV “cocktail”, which turned HIV infection from a death sentence into a disease that could be controlled indefinitely by taking a combination of mediations. The question has always been, however, when to start taking these drugs: wait until the immune system showed signs of damage, or as soon as a person found he was infected? A large global study just gave the answer: start the drugs as soon as a person learns he is infected.
The benefits of early treatment in the study were so clear that the researchers took the rare step of stopping the study a year before its scheduled conclusion. The results showed that people who were treated immediately were 53% less likely to die or suffer serious illness than those who waited to start the medications.
This so-called START study began in 2011, and was conducted in 35 countries. The study enrolled nearly 5000 men and women who were infected with the virus, but had never started treatment. Their immune systems still seemed to have normal strength. Half of the individuals were given the HIV “cocktail” of medications, and half were given placebo instead.
The benefits of early treatment were the same in low-, middle-, and high-income countries. Another huge advantage of early HIV treatment is that people taking the cocktail usually have a level of virus very far below people not on medication. With less virus in their bloodstream, they are much less likely to pass the disease on to others. So early treatment is not only beneficial to the individual taking the mediation, but is also a big advantage fr the public health, slowing spread of the disease.
Brazil has always been at the forefront of HIV treatment, and people who live in Brazil are fortunate that SUS (the government health program) will pay for the HIV medications. In many countries, HIV people have put off taking medications because the cost was prohibitive.
The important point is to get tested for the HIV virus. If your doctor does not suggest the test, ask for the test or go to your public health clinic where free testing and treatment is offered. If you are negative (no evidence of virus), then continue safe sex practices. If you are positive, the START study conclusively shows you will be healthier if you start the cocktail right away. In that way, you will also be contributing to slowing the international epidemic.
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