Does earlier HIV treatment impact development of AIDS? SPH professor Jim Neaton is leading a trial that looks to answer that very question.

A major new clinical trial seeks to determine whether HIV-infected individuals with no symptoms have less risk of developing AIDS or related illnesses if they begin taking treatments sooner rather than later.

School of Public Health professor Jim Neaton will lead the trial, which involves 4,000 HIV-infected participants at more than 250 clinical sites in 36 countries. Participants will be followed for up to five years.

The trial is the latest from the International Network for Strategic Initiatives in Global HIV Trials (INSIGHT), the world's largest HIV/AIDS clinical trial network, funded by the NIH's National Institute of Allergy and Infectious Diseases.

"There are different recommendations about when to treat HIV because the evidence is not robust," says Neaton. "That's why you need a very strong study design with randomization and a lot of people with long-term follow-up to really get the answer about risk versus benefit."

INSIGHT investigator Keith Henry, director of HIV clinical research at the Hennepin County Medical Center, says that risks include side effects, which, in rare instances, can be deadly. He says that cost is another factor to consider.

"A year of antiretroviral treatment and monitoring [in the U.S.] averages about $25,000 for a patient who is doing well. Forty years of that adds up to one million dollars," says Henry. "So having really good data about which groups of patients most benefit is crucial."