Prevention of HIV Transmission and the HPTN 052 Study

Annu Rev Med. 2020 Jan 27:71:347-360. doi: 10.1146/annurev-med-110918-034551. Epub 2019 Oct 25.

Abstract

The HIV Prevention Trials Network 052 study (HPTN 052) was a clinical trial designed to determine whether early treatment for HIV infection prevented transmission of the virus in couples where one partner was infected with HIV and the other was not, referred to as HIV serodiscordant or serodifferent couples. The study enrolled 1,763 couples at 13 sites in 9 countries in Asia, Africa, and the Americas. HPTN 052 demonstrated a minimum of 96% reduction of HIV in heterosexual couples ascribed to antiretroviral treatment; early treatment of HIV significantly reduced other infections in the HIV-infected subjects. This study, in conjunction with similar research, led to significant changes in international HIV treatment guidelines and the concept of treatment as prevention (TasP). This article provides the scientific background and history of how HPTN 052 came into being, the challenges it faced, and the ultimate impact it had on the fields of HIV treatment and prevention.

Keywords: ART; HIV Prevention Trials Network; HIV prevention; HPTN 052; TasP; antiretroviral therapy; serodiscordant couples; treatment as prevention; viral suppression.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Adult
  • Anti-HIV Agents* / administration & dosage
  • Anti-Retroviral Agents / administration & dosage
  • Clinical Trials as Topic
  • Female
  • HIV Infections* / drug therapy
  • HIV Infections* / prevention & control
  • HIV Seropositivity*
  • HIV-1 / drug effects
  • HIV-1 / isolation & purification
  • Humans
  • Incidence
  • Internationality
  • Male
  • Multicenter Studies as Topic
  • Practice Guidelines as Topic*
  • Prognosis
  • Risk Assessment
  • Sexual Partners
  • Treatment Outcome
  • Viral Load / drug effects

Substances

  • Anti-HIV Agents
  • Anti-Retroviral Agents