| Author | Cohen, Myron S. | |
| Author | Chen, Ying Q. | |
| Author | McCauley, Marybeth | |
| Author | Gamble, Theresa | |
| Author | Hosseinipour, Mina C. | |
| Author | Kumarasamy, Nagalingeswaran | |
| Author | Hakim, James G. | |
| Author | Kumwenda, Johnstone | |
| Author | Grinsztejn, Beatriz | |
| Author | Pilotto, Jose H. S. | |
| Author | Godbole, Sheela V. | |
| Author | Chariyalertsak, Suwat | |
| Author | Santos, Breno R. | |
| Author | Mayer, Kenneth H. | |
| Author | Hoffman, Irving F. | |
| Author | Eshleman, Susan H. | |
| Author | Piwowar-Manning, Estelle | |
| Author | Cottle, Leslie | |
| Author | Zhang, Xinyi C. | |
| Author | Makhema, Joseph | |
| Author | Mills, Lisa A. | |
| Author | Panchia, Ravindre | |
| Author | Faesen, Sharlaa | |
| Author | Eron, Joseph | |
| Author | Gallant, Joel | |
| Author | Havlir, Diane | |
| Author | Swindells, Susan | |
| Author | Elharrar, Vanessa | |
| Author | Burns, David | |
| Author | Taha, Taha E. | |
| Author | Nielsen-Saines, Karin | |
| Author | Celentano, David D. | |
| Author | Essex, Max | |
| Author | Hudelson, Sarah E. | |
| Author | Redd, Andrew D. | |
| Author | Fleming, Thomas R. | |
| Access date | 2016-12-01T15:43:34Z | |
| Available date | 2016-12-01T15:43:34Z | |
| Document date | 2016 | |
| Citation | COHEN, Myron S. et al. Antiretroviral Therapy for the Prevention of HIV-1 Transmission. New England Journal of Medicine, v. 375, n. 9, p. 830-839, Sept. 2016. | pt_BR |
| ISSN | 0028-4793 | pt_BR |
| URI | https://www.arca.fiocruz.br/handle/icict/16404 | |
| Language | eng | pt_BR |
| Publisher | Massachussets Medical Society | pt_BR |
| Rights | open access | pt_BR |
| Subject in Portuguese | HIV-1 | pt_BR |
| Subject in Portuguese | Prevenção | pt_BR |
| Subject in Portuguese | Terapia Anti-retroviral | pt_BR |
| Title | Antiretroviral Therapy for the Prevention of HIV-1 Transmission | pt_BR |
| Type | Article | pt_BR |
| DOI | 10.1056/NEJMoa1600693 | |
| Abstract | Background: An interim analysis of data from the HIV Prevention Trials Network (HPTN) 052 trial showed that antiretroviral therapy (ART) prevented more than 96% of genetically linked infections caused by human immunodeficiency virus type 1 (HIV-1) in serodiscordant couples. ART was then offered to all patients with HIV-1 infection (index participants). The study included more than 5 years of follow-up to assess the durability of such therapy for the prevention of HIV-1 transmission. Methods: We randomly assigned 1763 index participants to receive either early or delayed ART. In the early-ART group, 886 participants started therapy at enrollment (CD4+ count, 350 to 550 cells per cubic millimeter). In the delayed-ART group, 877 participants started therapy after two consecutive CD4+ counts fell below 250 cells per cubic millimeter or if an illness indicative of the acquired immunodeficiency syndrome (i.e., an AIDS-defining illness) developed. The primary study end point was the diagnosis of genetically linked HIV-1 infection in the previously HIV-1-negative partner in an intention-to-treat analysis. Results: Index participants were followed for 10,031 person-years; partners were followed for 8509 person-years. Among partners, 78 HIV-1 infections were observed during the trial (annual incidence, 0.9%; 95% confidence interval [CI], 0.7 to 1.1). Viral-linkage status was determined for 72 (92%) of the partner infections. Of these infections, 46 were linked (3 in the early-ART group and 43 in the delayed-ART group; incidence, 0.5%; 95% CI, 0.4 to 0.7) and 26 were unlinked (14 in the early-ART group and 12 in the delayed-ART group; incidence, 0.3%; 95% CI, 0.2 to 0.4). Early ART was associated with a 93% lower risk of linked partner infection than was delayed ART (hazard ratio, 0.07; 95% CI, 0.02 to 0.22). No linked infections were observed when HIV-1 infection was stably suppressed by ART in the index participant. Conclusions: The early initiation of ART led to a sustained decrease in genetically linked HIV-1 infections in sexual partners. (Funded by the National Institute of Allergy and Infectious Diseases; HPTN 052 ClinicalTrials.gov number, NCT00074581). | pt_BR |
| Affilliation | University of North Carolina at Chapel Hill. Department of Medicine. Chapel Hill, North Carolina, USA. | pt_BR |
| Affilliation | Fred Hutchinson Cancer Research Center. Divisions of Vaccine and Infectious Disease. Public Health Science. Seattle, Washington, USA. | pt_BR |
| Affilliation | FHI 360. Washington, DC, USA. | pt_BR |
| Affilliation | FHI 360. Durham, North Carolina, USA. | pt_BR |
| Affilliation | University of North Carolina at Chapel Hill. Department of Medicine. Chapel Hill, North Carolina, USA. | pt_BR |
| Affilliation | Gaitonde Center for AIDS Research and Education. Chennai, India. | pt_BR |
| Affilliation | University of Zimbabwe. Harare, Zimbabwe. | pt_BR |
| Affilliation | College of Medicine–Johns Hopkins Project. Blantyre, Malawi. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Pesquisa Clinica Evandro Chagas. Rio de Janeiro, RJ. Brasil. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de AIDS e Imunologia Molecular. Rio de Janeiro, RJ, Brasil / Hospital Geral de Nova Iguaçu, Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | National AIDS Research Institute. Pune, India. | pt_BR |
| Affilliation | Chiang Mai University. Research Institute for Health Sciences. Chiang Mai, Thailand. | pt_BR |
| Affilliation | Hospital Nossa Senhora da Conceicao/GHC. Servico de Infectologia. Porto Alegre, RS, Brasil. | pt_BR |
| Affilliation | Fenway Institute. Boston, USA. | pt_BR |
| Affilliation | University of North Carolina at Chapel Hill. Department of Medicine. Chapel Hill, North Carolina, USA. | pt_BR |
| Affilliation | Johns Hopkins University School of Medicine. Departments of Pathology. Baltimore, USA. | pt_BR |
| Affilliation | Johns Hopkins University School of Medicine. Departments of Pathology. Baltimore, USA. | pt_BR |
| Affilliation | Fred Hutchinson Cancer Research Center. Statistical Center for HIV/AIDS Research and Prevention. Seattle, USA. | pt_BR |
| Affilliation | Fred Hutchinson Cancer Research Center. Divisions of Vaccine and Infectious Disease. Seattle, USA. | pt_BR |
| Affilliation | Botswana Harvard AIDS Institute. Gaborone, Botswana. | pt_BR |
| Affilliation | Centers for Disease Control and Prevention (CDC) Division of HIV/AIDS Prevention/KEMRI– CDC Research and Public Health Collaboration HIV Research Branch, Kisumu, Kenya. | pt_BR |
| Affilliation | University of the Witwatersrand. Perinatal HIV Research Unit. Johannesburg, South Africa. | pt_BR |
| Affilliation | University of the Witwatersrand. Department of Medicine. Faculty of Health Sciences. Johannesburg, South Africa. | pt_BR |
| Affilliation | University of North Carolina at Chapel Hill. Department of Medicine. Chapel Hill, North Carolina, USA. | pt_BR |
| Affilliation | Southwest CARE Center. Santa Fe. Mexico. | pt_BR |
| Affilliation | University of California. San Francisco, CA, USA. | pt_BR |
| Affilliation | University of Nebraska Medical Center, Omaha, Nebraska, USA. | pt_BR |
| Affilliation | Johns Hopkins Bloomberg School of Public Health. Division of AIDS. Maryland, USA. | pt_BR |
| Affilliation | Johns Hopkins Bloomberg School of Public Health. Division of AIDS. Maryland, USA. | pt_BR |
| Affilliation | Jonhs Hopkins University School of Medicine. Department of Epidemiology. Bloomberg School of Public Health. Baltimore, USA. | pt_BR |
| Affilliation | David Geffen UCLA School of Medicine. Division of Infectious Diseases. Los Angeles. CA, USA. | pt_BR |
| Affilliation | Johns Hopkins Bloomberg School of Public Health. Baltimore, USA. | pt_BR |
| Affilliation | Harvard School of Public Health. Boston, USA. | pt_BR |
| Affilliation | Jonhs Hopkins University School of Medicine. Department of Patology. Baltimore, USA. | pt_BR |
| Affilliation | National Institutes of Health. National Institute of Allergy and Infectious Diseases. Laboratory of Immunoregulation. Bethesda, Maryland, USA. | pt_BR |
| Affilliation | University of Washington. Fred Hutchinson Cancer Research Center. Department of Biostatistics. Seattle, USA. | pt_BR |
| Subject | Antiretroviral Therapy | pt_BR |
| Subject | Prevention | pt_BR |
| Subject | HIV-1 Transmission | pt_BR |
| e-ISSN | 1533-4406 | |
