Starting HIV treatment at CD4 count above 500 reduces the risk of serious illness and death by 44%, African Temprano trial shows

Keith Alcorn
Original Article:

Starting HIV treatment at a CD4 cell count above 500 reduced the risk of serious illness including tuberculosis (TB), and death, by 44% when compared to starting treatment according to World Health Organization (WHO) guidelines, results from the seven-year Temprano study show. The findings were presented on Wednesday at the Conference on Retroviruses and Opportunistic Infections (CROI 2015) in Seattle, USA.

The study also found that a six-month course of isoniazid preventive treatment reduced the risk of developing TB by 35%.

Temprano was designed to test the safety and efficacy of early HIV treatment initiation compared to standard treatment initiation in a lower-income setting with a high prevalence of TB and bacterial infections. The study was conducted in Ivory Coast by the French AIDS research institute ANRS.

The study was also designed to test whether isoniazid preventive therapy (IPT) offered additional benefit in preventing TB for people living with HIV, over and above taking antiretroviral therapy. Despite evidence that it is effective in preventing TB in people living with HIV, IPT is not implemented in many settings, due in part to difficulties in ruling out active TB, but also because of concerns that it will lead to resistance to isoniazid in people who turn out to have active TB after starting IPT.

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