SPARTAC (Short Pulse Anti Retroviral Therapy at HIV Seroconversion), is the largest randomised controlled trial ever undertaken in primary (recent) HIV infection. The study ran between 2003 and 2011 across eight countries.
SPARTAC examined whether treating people recently infected with HIV (within 6 months of infection) with anti-HIV drugs for a short period of time could slow down the damage caused by HIV to the immune system and consequently delay the need to start long-term treatment.
The SPARTAC team recruited enough participants to ensure that any differences between the study groups would be detectable, and that any findings from the study would not be due to chance: 366 adults – mainly heterosexual women and men who have sex with men (MSM) – took part from 35 sites in Australia, Brazil, Ireland, Italy, Spain, South Africa, Uganda, and the UK. SPARTAC participants were allocated into one of three treatment strategy groups randomly, like the roll of dice, by the Medical Research Council Clinical Trials Unit. The three groups were:
- a short-course of ART for 12 weeks (ART-12);
- a short-course of ART for 48 weeks (ART-48);
- no ART (the current standard of care (SOC) for people recently infected with HIV).
The SPARTAC team followed up participants for at least 3.5 years measuring when a participant’s CD4 count had fallen below 350 cells per mm3 blood (a measure of the strength of the immune system) and/or they started long-term treatment. The team are now working to compare how the three groups fared in terms of the measurements taken.
Only people with a confirmed recent HIV infection (a negative HIV test up to 6 months before a positive one) were eligible to participate. All those eligible were fully informed about what it meant to be part of the study before deciding to enrol. All participants had access to treatment according to national treatment guidelines should they become ill.
The SPARTAC study was conducted in resource-limited and resource-rich settings and designed to provide robust and conclusive results. This trial differs from previous studies looking into treating people recently infected with HIV which were mostly carried out in resource-rich countries.