What is the result of early initiation of antiretroviral therapy (ART) during the acute seroconversion period in HIV infection?

Updated: Jul 01, 2019
  • Author: Nicholas John Bennett, MBBCh, PhD, MA(Cantab), FAAP; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

One study has suggested that extremely early initiation of antiretroviral therapy during this acute seroconversion period (within 2 weeks of converting) may result in better long-term CD4 counts and steady-state viral load. Although the numbers were small, acutely-treated individuals had a mean of 0.48 Log10 copies/ml lower viral load, and higher CD4 counts (average 112 cells/µL) than an untreated cohort. The effects were less pronounced and lasted for a shorter time for patients with an “early” initiation of therapy (within 2 weeks to 6 months of seroconversion). [117]

There have been attempts made to characterize the timeframe of seroconversion, especially in patients without a clear source of exposure which can be dated accurately. Although imperfect, algorithms based on the number of Western Blot bands and the actual ELISA signal compared to the positive cutoff may have some utility here. [118]


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