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.