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Early ART Prevents HIV Transmission
Hi. This is Paul Sax from Brigham and Women's Hospital and Harvard Medical School. I hope you're all having a very nice summer.
I recently returned from the International AIDS Society (IAS) Meeting in Rome, where the big news was HIV Prevention Trials Network (HPTN) study 052. I spoke about HPTN 052 the last time I posted a video. At IAS, we were given some additional details from the study. In addition, I just want to mention that the full paper was published on the same day that the presentations took place.
Here are some additional interesting facts from HPTN 052, the study that demonstrated that treatment indeed prevents transmission of HIV -- a 96% protective effect. The first is that the only case of linked transmission in the study from a patient who received early therapy almost certainly occurred before the patient achieved virologic suppression. It was in the first few months of treatment.
The second point is that there have been some additional transmissions after the study was stopped, and those transmissions all occurred in the delayed arm. Therefore, the efficacy of treatment might be even better than originally estimated.
The third thing that I want to mention is that condoms were independently associated with a reduced risk for transmission -- 100% condom use vs less than 100%. Those who reported 100% use had a significantly lower likelihood of acquiring HIV.
The fourth point I want to make is that the serious clinical adverse events were equal between study arms, suggesting that antiretroviral therapy was extremely well tolerated in this very broad-range population. Overall, it was the biggest story of the meeting. It was followed by 2 additional presentations on important preexposure prophylaxis (PrEP) studies, studies that both showed a favorable effect. The first was the Partners PrEP study in serodiscordant couples, and the second was the TDF2 study. Both studies were done in sub-Saharan Africa, and both studies showed a 60%-70% efficacy in PrEP for reducing the risk of acquiring HIV.
Those were the very exciting news items from IAS on prevention. In my next video, I'll talk about some treatment studies that may have flown under the radar. I hope you enjoy the rest of your summer. The weather here in Boston is beautiful. Take care.
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