title: Immunological and virological benefits resulted from short-course treatment during primary HIV infection: a meta-analysis.
abstract: OBJECTIVE
  To assess the potential immunological and virological effects that result from short-course antiretroviral treatment during primary HIV infection (PHI). And to investigate whether treatment initiation time, treatment duration and follow-up time after treatment interruption would affect these post-treatment immunovirological outcomes.
  
  
  METHODS
  We systematically searched PubMed, Cochrane Library (to September 2013) and retrieved conference abstracts for studies regarding effects of early treatment during PHI on CD4 count and viral load (VL). Using the method of calculating weighted mean differences with Stata11.0, we conducted meta-analyses on the effect of early treatment on CD4 count and VL. Then we performed subgroup analyses by follow-up time after treatment interruption, treatment initiation time and treatment duration. Baseline immunovirological characteristics were also analyzed to account for potential bias.
  
  
  RESULTS
  Compared to the untreated arm, treatment during PHI not only increased CD4 count by 85.92 cells/μl but also lowered viral load by 0.30 log copies/ml within one year after treatment interruption. However, the benefits declined gradually, reaching no significance 12-24 months after treatment interruption. Baseline immunovirological characteristics and sensitivity analyses of randomized controlled trials indicated that the benefits mentioned above were underestimated. Extending treatment duration beyond 12 months did not increase efficacy.
  
  
  CONCLUSIONS
  Short-course treatment during PHI was associated with immunological and virological benefits which last for at least one year after treatment interruption. The conclusions from our study would help the decision-making in the clinical management of PHI.
authors: Key Laboratory of AIDS Immunology of Ministry of Health, Department of Laboratory Medicine, The First Hospital of China Medical University, Shenyang, Liaoning, China.
authors: Jingjing
authors: J
authors: Chen
authors: Xiaoxu
authors: X
authors: Han
authors: Minghui
authors: M
authors: An
authors: Jing
authors: J
authors: Liu
authors: Junjie
authors: J
authors: Xu
authors: Wenqing
authors: W
authors: Geng
authors: Yangtao
authors: Y
authors: Ji
authors: Hong
authors: H
authors: Shang
mesh_terms: D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology* / Q000821:virology*; D015497:HIV-1 / Q000276:immunology*; D006801:Humans; D013997:Time Factors; D016896:Treatment Outcome; D019562:Viral Load