SPARTAC results

The SPARTAC results were published in January 2013 in the New England Journal of Medicine (N Engl J Med 368;3 January 17, 2013).

Collecting measurements over an average period of 4 years allowed the SPARTAC team to obtain robust evidence on the impact a short course of ART in recent HIV infection has on the progression of HIV disease, compared to participants who received the current standard of care of no early treatment.

Summary

Giving people recently infected with HIV 48 weeks of treatment had some advantages, compared to no early treatment:

• It delayed the time to needing long-term treatment, though not much longer than the time already spent on 48 weeks of treatment (average of 65 weeks).
• Overall the group had healthier immune systems (an average of 138 more CD4 cells per mm³ blood) and lower amounts of virus in the blood (an average of 0.4 log₁₀ copies of HIV RNA per millilitre blood more).
• These advantages were greater the closer the 48 weeks of treatment was started to the time of HIV infection.

There was no effect found in giving people recently infected with HIV 12 weeks of treatment, compared to no early treatment. There was no evidence of harm of early treatment in terms of deaths, adverse events and the effectiveness of long-term treatment later on.

What’s the science behind these findings?

More research is needed to understand why 48 weeks of treatment given to participants recently infected with HIV had certain advantages. Our findings suggest that it may be due to 48 weeks of treatment reducing the amount of hidden virus in the body (viral reservoir size).