Every year, Science announces the Breakthrough of the Year, an honor bestowed to research that impacts a wide array of scientists and has far-reaching and profound implications. The winner of Breakthrough of the Year, 2011 went to “HIV Treatment as Prevention,” based on the HPTN 052 phase III clinical trial that reported a 96% reduction in HIV transmission between serodiscordant couples when early antiretroviral therapy, compared to delayed, was administered (Cohen et al. NEJM Aug 2011).
It has been well documented that combination antiretroviral therapy can lower HIV viral load and delay HIV disease progression to AIDS, however the timing of antiretroviral administration to those infected with HIV has been controversial.
HIV Prevention Trials Network (HPTN) investigators, including VIDD and SCHARP members Dr. Ying Chen and Dr. Thomas Fleming and VIDD senior staff scientist Dr. Lei Wang, designed and implemented a long-term, large-scale, randomized controlled phase III study to compare prevention of HIV transmission and development of HIV-related illness in serodiscordant couples after administration of antiretroviral therapy immediately after HIV diagnosis and at the time of low CD4 T-cell counts.
This study is the first clinical trial demonstrating that early antiretroviral therapy results in a considerable reduction in the risk of HIV transmission between serodiscordant couples and progression to late-stage disease.
“In combination with other promising clinical trials, the results have galvanized efforts to end the world’s AIDS epidemic in a way that would have been inconceivable even a year ago,” wrote Science Editor-in-Chief Bruce Alberts. The choice for the Breakthrough of the Year involved considerable deliberation among Science Editors, according to Alberts.
This study, which included over 1,700 participants from nine countries, provides hope for ameliorating the detrimental effects of infection and optimism for those infected with HIV.
To read the full articles »
Cohen, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011 Aug 11;365(6):493-505.
Cohen, J. Breakthrough of the year. HIV treatment as prevention. Science. 2011 Dec 23;334(6063):1628.
Alberts' Editorial Breakthrough of the Year, 2011.