Intensive or early therapy

David Ho and others have proposed that antiretroviral regimens containing five or more drugs might suppress HIV more rapidly and completely, thereby improving the likelihood of viral eradication. Other researchers have suggested that treatment during the first few weeks of HIV infection – known as primary or acute infection – might enable virus eradication. This thinking is based on the fact that newly infected people usually have less diverse virus, strong immune responses, and their ‘sanctuary’ sites may not yet be infected.

Patients who start treatment very early seem to have lower levels of HIV genetic material in latent CD4 T-cells.¹ In a study of seven patients who started antiretroviral therapy an average of seven months after seroconversion and stayed on treatment for an average of about three years, Fauci’s group found that the reservoir of resting HIV-infected CD4 cells decreased by 50% every five months.²

However, no patients so far – including those treated during seroconversion itself – are known to have completely eradicated HIV through antiretroviral treatment alone.