Updated guidelines recommend immediate antiretroviral treatment (ART) during acute HIV infection (AHI), but efficacy data on regimens during AHI are limited.
We provide final data on a prospective, single-arm 96-week open label study of once daily emtricitabine/tenofovir/efavirenz initiated during AHI. The primary endpoint was the proportion of responders with HIV RNA <200 copies/mL by week 24. We examined time-to-viral-suppression, retention and CD8 cell activation through week 96 in relation to baseline characteristics. RESULTS
Between January 2005 and December 2011, 92 AHI participants enrolled. Most participants (78%) were MSM, and 42% were young MSM (18-25 years of age). Two participants withdrew leaving 90 patients for analysis. Eighty-one (90%) remained on therapy and achieved viral suppression to <200 copies/mL by week 24, and 71 (79%) to <50 copies/mL at week 48. The median time from ART initiation to suppression <200 copies/mL was 65 days (range 7-523) and to <50 copies/mL was 105 days (range 14-523). The frequency of immune activation declined from a median of 67% to 16% through week 96. Retention on study was maintained in 92% of participants at week 48 and in 83% through week 96. Among 75 participants retained through week 96, 92% were suppressed to <50 copies/mL. Among 39 young MSM, 79% completed a week 96 visit and 67% were suppressed at week 96. CONCLUSION
ART during AHI resulted in rapid and sustained viral suppression with high rates of retention in care and on ART in this cohort including a large proportion of young MSM.