Immediate HIV Treatment Initiation With Integrase Inhibitors Leads to Large Drop in Secondary HIV Transmission Among MSM

published on September 21, 2020 by Terri Wilder, M.S.W. and Myles Helfand, in TheBodyPro

We know that early HIV treatment initiation is a good idea—not just for the health of a person living with HIV, but from an HIV prevention standpoint as well. We also know that integrase inhibitors have developed a pretty sterling reputation as an excellent first-line option.

But when it comes to brass tacks—for instance, the ability of a person’s first HIV treatment regimen to quickly suppress their viral load and eliminate the risk for secondary sexual HIV transmission—how well do integrase inhibitors really measure up relative to the other excellent antiretroviral options we have on the menu?

Quite well, it appears, according to recently published research.

A large modeling study appearing in PLoS One in July found that initiating HIV treatment with an integrase inhibitor–based regimen immediately after a person is diagnosed led to an 88% reduction in onward HIV transmission risk over the next eight weeks among men who have sex with men (MSM), when compared to starting treatment 28 days after diagnosis. That’s a moderately higher rate reduction than the researchers found for efavirenz-based therapy (76%) and considerably better than for boosted darunavir–based therapy (58%).

To discuss the findings in more detail and examine their clinical ramifications, we spoke with two HIV experts: Juan Berenguer, M.D., Ph.D., and Antonio Urbina, M.D.

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Immediate HIV Treatment Initiation With Integrase Inhibitors Leads to Large Drop in Secondary HIV Transmission Among MSM

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