According to a recent report in the Journal of Infection, there is a lack of data on the optimal timing to begin antiretroviral therapy (ART) in patients with human immunodeficiency virus (HIV) and talaromycosis. Thus, in a randomized study co-led by Yuanyuan Qin, Yihong Zhou, and Songtao Liu, investigators tested ART administration timings and found that early ART initiation yielded a more favorable prognosis than deferred ART in HIV-positive patients with talaromycosis.

The trial included 228 patients from 15 hospitals in China. Participants were randomly assigned to either an early group, where ART was initiated within two weeks of enrollment, or a deferred group, where ART was started at the two week mark. The primary outcome was all-cause mortality during the 48 weeks following enrollment.

The researchers observed a significant difference in mortality between the early and deferred ART group at 2.2% versus 8.9%, respectively (95% confidence interval [CI], –0.15 to 14.05; p = 0.049). Composited acquired immunodeficiency syndrome (AIDS)-related adverse events or death outcomes were also lower in the early ART group versus the deferred group (95% CI, 2.93–19.23; p = 0.008).

To the authors’ knowledge, this was the first study to investigate ART initiation timing after talaromycosis diagnosis. They concluded that their findings “indicate that early ART initiation should be actively considered for HIV-infected patients with talaromycosis.”

Source: Journal of Infection