7th International AIDS Society Conference, Kuala Lumpur, June 2013:
A non-randomized Swiss study of 290 people showed that using a novel scoring system of six surrogate markers could help establish best practices for starting HIV meds in early infection — an area of HIV care that could use better tools for guiding medical practice. The system, called ARSSS (Acute Retroviral Syndrome Severity Score), may better identify which individuals should start treatment immediately.
Researchers assigned a score to each of 6 surrogate markers: severe nerve-related symptoms (3), in-patient treatment (3), 50yo or older (1), current sexually transmitted infection (1), higher liver enzymes (1), and lower platelet count (1). They then compared total scores to baseline viral load and CD4 count as well as viral set point (>60 days after estimated time of infection).
The overall average score was 2.3 (range 0–10). People with higher total scores had a significantly lower CD4 count and a higher viral load and viral set point. However, in those who had a planned treatment interruption (40 people), this system did not correlate to the viral set point.
The researchers propose that ARSSS could help predict which patients may have a faster progression of HIV disease, thereby pointing to the need for earlier or immediate treatment. Although this is an interesting system to help inform providers and patients on when to start, it needs further study to confirm the accuracy and usefulness of these results.