Anti-HIV Medications for People Recently Infected With HIV

Although some doctors favor starting anti-HIV treatment as soon as possible after patients learn they are infected, it is not known if treatment for recently infected patients results in slower progression of HIV disease. This study will compare the virologic outcomes of recently infected adults who receive highly active antiretroviral therapy (HAART) with those who receive no treatment. This study will also compare the effects of treatment on patients who enroll within 3 months of seroconversion (acute seroconverters) with patients who enroll within 3 to 12 months of seroconversion (early seroconverters).

This study will last at least 3 years. Participants will be randomly assigned to one of two groups. Group 1 will receive HAART for 1 year; Group 2 will receive no treatment. There will be at least 20 study visits over the 3-year study period. Blood collection will occur at all study visits. A physical exam, medical and medication history, and risk behavior assessment will occur at most visits; participants will also be asked to complete an adherence questionnaire at most visits.

Inclusion criteria

• Documented acute or recent HIV infection (infected in the past 12 months) as defined in the study protocol
• Antiretroviral naive. Participants who have taken antiretrovirals for postexposure prophylaxis are eligible for this study.
• Able to swallow tablets or capsules
• Willing to use acceptable forms of contraception

Exclusion criteria

• Physician unable to design a potentially effective HAART regimen based on results of genotypic resistance testing
• Two CD4 counts of less than 350 cells/mm3 obtained at least 7 days apart within 30 days of study entry
• Viral load less than 5,000 copies/ml within 30 days of study entry in participants who have been infected with HIV-1 for more than six months prior to study entry
• Use of systemic cancer chemotherapy, systemic investigational agents, specific antiretroviral medications, or immunomodulators (growth factors, systemic corticosteroids, HIV vaccines, immune globulin, interleukins, interferons) within 30 days prior to study entry
• Current alcohol or drug use that, in the opinion of the investigator, would interfere with the study
• Serious illness requiring systemic treatment or hospitalization until participant either completes therapy or is clinically stable on therapy for at least 7 days prior to study entry
• Currently involuntarily incarcerated for treatment of either a psychiatric or physical (e.g., infectious disease) illness
• Pregnancy or breastfeeding