SEATTLE, WA – Results from the French-sponsored Temprano clinical trial in Cote d’lvoire presented here Wednesday show that immediate HIV treatment and six months of isoniazid preventive therapy dramatically and independently decrease the risk of severe illness, especially tuberculosis, in persons with HIV infection. The study, conducted in nine health centers in Abidjan from March 2008 through January 2015 enrolled 2,056 patients into four groups — receiving immediate antiretroviral therapy, immediate antiretroviral therapy with 6 months of IPT, antiretroviral therapy based on World Health Organization guidelines at the time of study entry, and antiretroviral therapy based on WHO guidelines plus six months of IPT. The goal was to evaluate the impact of each intervention on severe HIV-related illness. The risk of illness — most commonly tuberculosis or invasive bacterial diseases — was 44 percent lower with early HIV treatment versus the treatment start recommended by WHO guidelines and 35 percent lower with IPT compared to no IPT. These outcomes are especially notable because they extended to patients with CD4 counts of more than 500.
Christine Danel, who presented the results for the French ANRS group, argued that immediate antiretroviral therapy plus six months of IPT should become the HIV standard of care, and noted that the investigators plan to present their results to the Cote d’Ivoire Ministry of Health and to submit the results to the WHO for consideration.