海外ジャーナル
HIV-1血清陽性者への早期抗ウイルス療法、陰性パートナーへの伝播予防に有効
2011年07月21日 ソース：NEJM（論文一覧） カテゴリ： 血液疾患（関連論文） ・感染症（関連論文） ・投薬に関わる問題（関連論文）
文献：Cohen MS et al.Prevention of HIV-1 Infection with Early Antiretroviral Therapy.July 18, 2011 (10.1056/NEJMoa1105243).
HIV-1血清陽性者と陰性者のカップル1763組を対象に、陰性パートナーへのウイルス伝播予防における抗ウイルス療法の開始時期の影響を無作為化比較試験で検討。陽性パートナーからの感染が28件見られたが、このうち1件のみが早期治療開始群で、残りはCD4数減少後またはHIV-1関連症状発症後に治療を開始した群だった。
http://www.m3.com/news/THESIS/2011/07/21/11452/?portalId=mailmag&mm=MD110721_XXX
原文（NEJM）を読む
Original Article
Prevention of HIV-1 Infection with Early Antiretroviral Therapy
Myron S. Cohen, M.D., Ying Q. Chen, Ph.D., Marybeth McCauley, M.P.H., Theresa Gamble, Ph.D., Mina C. Hosseinipour, M.D., Nagalingeswaran Kumarasamy, M.B., B.S., James G. Hakim, M.D., Johnstone Kumwenda, F.R.C.P., Beatriz Grinsztejn, M.D., Jose H.S. Pilotto, M.D., Sheela V. Godbole, M.D., Sanjay Mehendale, M.D., Suwat Chariyalertsak, M.D., Breno R. Santos, M.D., Kenneth H. Mayer, M.D., Irving F. Hoffman, P.A., Susan H. Eshleman, M.D., Estelle Piwowar-Manning, M.T., Lei Wang, Ph.D., Joseph Makhema, F.R.C.P., Lisa A. Mills, M.D., Guy de Bruyn, M.B., B.Ch., Ian Sanne, M.B., B.Ch., Joseph Eron, M.D., Joel Gallant, M.D., Diane Havlir, M.D., Susan Swindells, M.B., B.S., Heather Ribaudo, Ph.D., Vanessa Elharrar, M.D., David Burns, M.D., Taha E. Taha, M.B., B.S., Karin Nielsen-Saines, M.D., David Celentano, Sc.D., Max Essex, D.V.M., and Thomas R. Fleming, Ph.D. for the HPTN 052 Study Team
July 18, 2011 (10.1056/NEJMoa1105243)
Comments open through July 25, 2011
AbstractArticleReferencesComments Background
Antiretroviral therapy that reduces viral replication could limit the transmission of human immunodeficiency virus type 1 (HIV-1) in serodiscordant couples.
Full Text of Background...
Methods
In nine countries, we enrolled 1763 couples in which one partner was HIV-1–positive and the other was HIV-1–negative; 54% of the subjects were from Africa, and 50% of infected partners were men. HIV-1–infected subjects with CD4 counts between 350 and 550 cells per cubic millimeter were randomly assigned in a 1:1 ratio to receive antiretroviral therapy either immediately (early therapy) or after a decline in the CD4 count or the onset of HIV-1–related symptoms (delayed therapy). The primary prevention end point was linked HIV-1 transmission in HIV-1–negative partners. The primary clinical end point was the earliest occurrence of pulmonary tuberculosis, severe bacterial infection, a World Health Organization stage 4 event, or death.
Full Text of Methods...
Results
As of February 21, 2011, a total of 39 HIV-1 transmissions were observed (incidence rate, 1.2 per 100 person-years; 95% confidence interval [CI], 0.9 to 1.7); of these, 28 were virologically linked to the infected partner (incidence rate, 0.9 per 100 person-years, 95% CI, 0.6 to 1.3). Of the 28 linked transmissions, only 1 occurred in the early-therapy group (hazard ratio, 0.04; 95% CI, 0.01 to 0.27; P<0.001). Subjects receiving early therapy had fewer treatment end points (hazard ratio, 0.59; 95% CI, 0.40 to 0.88; P=0.01).
Full Text of Results...
Conclusions
The early initiation of antiretroviral therapy reduced rates of sexual transmission of HIV-1 and clinical events, indicating both personal and public health benefits from such therapy. (Funded by the National Institute of Allergy and Infectious Diseases and others; HPTN 052 ClinicalTrials.gov number, NCT00074581.)
http://www.nejm.org/doi/full/10.1056/NEJMoa1105243
HIV-1血清陽性者への早期抗ウイルス療法、陰性パートナーへの伝播予防に有効
2011年07月21日 ソース：NEJM（論文一覧） カテゴリ： 血液疾患（関連論文） ・感染症（関連論文） ・投薬に関わる問題（関連論文）
文献：Cohen MS et al.Prevention of HIV-1 Infection with Early Antiretroviral Therapy.July 18, 2011 (10.1056/NEJMoa1105243).
HIV-1血清陽性者と陰性者のカップル1763組を対象に、陰性パートナーへのウイルス伝播予防における抗ウイルス療法の開始時期の影響を無作為化比較試験で検討。陽性パートナーからの感染が28件見られたが、このうち1件のみが早期治療開始群で、残りはCD4数減少後またはHIV-1関連症状発症後に治療を開始した群だった。
http://www.m3.com/news/THESIS/2011/07/21/11452/?portalId=mailmag&mm=MD110721_XXX
原文（NEJM）を読む
Original Article
Prevention of HIV-1 Infection with Early Antiretroviral Therapy
Myron S. Cohen, M.D., Ying Q. Chen, Ph.D., Marybeth McCauley, M.P.H., Theresa Gamble, Ph.D., Mina C. Hosseinipour, M.D., Nagalingeswaran Kumarasamy, M.B., B.S., James G. Hakim, M.D., Johnstone Kumwenda, F.R.C.P., Beatriz Grinsztejn, M.D., Jose H.S. Pilotto, M.D., Sheela V. Godbole, M.D., Sanjay Mehendale, M.D., Suwat Chariyalertsak, M.D., Breno R. Santos, M.D., Kenneth H. Mayer, M.D., Irving F. Hoffman, P.A., Susan H. Eshleman, M.D., Estelle Piwowar-Manning, M.T., Lei Wang, Ph.D., Joseph Makhema, F.R.C.P., Lisa A. Mills, M.D., Guy de Bruyn, M.B., B.Ch., Ian Sanne, M.B., B.Ch., Joseph Eron, M.D., Joel Gallant, M.D., Diane Havlir, M.D., Susan Swindells, M.B., B.S., Heather Ribaudo, Ph.D., Vanessa Elharrar, M.D., David Burns, M.D., Taha E. Taha, M.B., B.S., Karin Nielsen-Saines, M.D., David Celentano, Sc.D., Max Essex, D.V.M., and Thomas R. Fleming, Ph.D. for the HPTN 052 Study Team
July 18, 2011 (10.1056/NEJMoa1105243)
Comments open through July 25, 2011
AbstractArticleReferencesComments Background
Antiretroviral therapy that reduces viral replication could limit the transmission of human immunodeficiency virus type 1 (HIV-1) in serodiscordant couples.
Full Text of Background...
Methods
In nine countries, we enrolled 1763 couples in which one partner was HIV-1–positive and the other was HIV-1–negative; 54% of the subjects were from Africa, and 50% of infected partners were men. HIV-1–infected subjects with CD4 counts between 350 and 550 cells per cubic millimeter were randomly assigned in a 1:1 ratio to receive antiretroviral therapy either immediately (early therapy) or after a decline in the CD4 count or the onset of HIV-1–related symptoms (delayed therapy). The primary prevention end point was linked HIV-1 transmission in HIV-1–negative partners. The primary clinical end point was the earliest occurrence of pulmonary tuberculosis, severe bacterial infection, a World Health Organization stage 4 event, or death.
Full Text of Methods...
Results
As of February 21, 2011, a total of 39 HIV-1 transmissions were observed (incidence rate, 1.2 per 100 person-years; 95% confidence interval [CI], 0.9 to 1.7); of these, 28 were virologically linked to the infected partner (incidence rate, 0.9 per 100 person-years, 95% CI, 0.6 to 1.3). Of the 28 linked transmissions, only 1 occurred in the early-therapy group (hazard ratio, 0.04; 95% CI, 0.01 to 0.27; P<0.001). Subjects receiving early therapy had fewer treatment end points (hazard ratio, 0.59; 95% CI, 0.40 to 0.88; P=0.01).
Full Text of Results...
Conclusions
The early initiation of antiretroviral therapy reduced rates of sexual transmission of HIV-1 and clinical events, indicating both personal and public health benefits from such therapy. (Funded by the National Institute of Allergy and Infectious Diseases and others; HPTN 052 ClinicalTrials.gov number, NCT00074581.)
http://www.nejm.org/doi/full/10.1056/NEJMoa1105243