Navigation Links
Another Study Supports Early HIV Therapy
Date:4/9/2009

New British findings echo those of an American team

THURSDAY, April 9 (HealthDay News) -- Antiretroviral treatment for HIV should begin earlier than it does for many patients, say researchers who analyzed data on more than 45,000 HIV-infected patients in Europe and North America.

The new findings come on the heels of a similar study, reported last week in the New England Journal of Medicine. In that study, researchers at the University of Washington, Seattle, found that starting therapy earlier -- before the body's immune system is too badly weakened -- rather than later in the infection process, boosted survival by up to 94 percent.

There's ongoing debate about when it's best to initiate HIV therapy. If treatment begins too late, treatment may not be as effective. But starting antiretroviral treatment early may increase the drugs' toxic effects.

The new findings, published online Wednesday in The Lancet, suggest that the minimum CD4-cell count threshold for the start of combination antiretroviral therapy should be 350 cells per microliter of blood, which is at the upper limit of levels for starting this drug regimen as currently recommended in many countries.

Levels of CD4 immune T-cells in the blood are considered an indicator of HIV's advance, with lower cell counts signaling that the virus has progressed.

Jonathan Sterne, of the University of Bristol in the United Kingdom, and colleagues found that deferring therapy until a CD4-cell count reached 251 to 350 cells per microliter was associated with a 28 percent higher rate of AIDS and death, compared to commencing therapy when the CD4-cell count was at a higher level of 351 to 450 cells per microliter.

Based on the findings, the researchers concluded that 350 cells per microliter should be the minimum threshold at which antiretroviral therapy is started.

"Our findings should help to guide physicians and patients in deciding when to start antiretroviral treatment," the researchers wrote.

They noted that the "International AIDS Society USA panel recommended in August, 2008, that antiretroviral therapy is started in individuals with CD4-cell counts less than 350 cells per microliter, and that this decision should be individualized when the CD4-cell count is greater than 350 cells per microliter. Recent US and European guidelines make similar recommendations."

"Unfortunately, many patients are not diagnosed with HIV until their CD4 count has fallen well below 350 cells per microliter, sometimes even below 200 cells per microliter," the UK team said. "It is important that people at possible risk of having HIV get tested regularly so that if found to be infected they can receive the necessary care and treatment."

But, two experts noted in an accompanying editorial that "the question of when to start ART might have more than one right answer," especially in poorer countries where access to medical resources is limited.

World Health Organization "guidelines for resource-limited settings currently recommend initiation of [antiretroviral therapy] before blood CD4 counts fall below 200 cells per microliter, with an upper threshold of 350 cells per microliter," they wrote. "To inform these recommendations, randomized controlled trials should include patients living in resource-limited settings." The editorial was written by Dr. Robin Wood, of the Desmond Tutu HIV Center at the University of Cape Town, South Africa, and Dr. Stephen D. Lawn, of the center and the London School of Hygiene and Tropical Medicine.

More information

The U.S. National Institute of Allergy and Infectious Diseases has more about HIV treatment.



-- Robert Preidt



SOURCE: The Lancet, news release, April 8, 2009


'/>"/>
Copyright©2009 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. American College of Pediatricians: Another Blow to Childrens Rights
2. TRICOR Systems Inc. Receives ISO 13485 Certification; Contract Manufacturer Achieves Another Significant Milestone in 32 Year History
3. Set Up Your Computer to Work in Another Language – New Tips at Argotrans.com
4. Pennsylvanians Encouraged to Take Another Look at COBRA Options
5. Is one diet as good as another? U of I study says no and tells you why
6. Acuo Technologies(R) Announces Another Record Sales and Implementation Growth
7. Exacerbations in COPD: One thing leads to another
8. Medical research community needs to speak louder to prevent another Canadian brain drain
9. Agresso Wins Another $1 Million+ Deal in Health Care Sector
10. Another reason to get your hands dirty
11. Another reason to avoid high-fat diet -- it can disrupt our biological clock
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Another Study Supports Early HIV Therapy
(Date:10/13/2017)... TX (PRWEB) , ... October 13, 2017 , ... ... planning agency serving communities in the greater Dallas, Miami, and Raleigh regions, is ... boy fighting to overcome a rare and deadly chromosome abnormality. , After struggling ...
(Date:10/13/2017)... ... ... The American Board of Family Medicine's (ABFM) Board of Directors has selected Warren ... James C. Puffer upon his retirement. Dr. Newton will serve in the position of ... end of 2018. Upon assuming the role of President and CEO on January 1, ...
(Date:10/13/2017)... ... October 13, 2017 , ... Lori R. Somekh, founder of ... ElderCounsel, a national organization of elder law and special needs planning attorneys. “Membership in ... It also provides a forum to network with elder law attorneys nationwide,” said Somekh. ...
(Date:10/13/2017)... New York, NY (PRWEB) , ... October 13, 2017 , ... ... most influential people in business to advocate for action towards gender equality at their ... 18,000 views from around the globe, and reached a social audience of over 3 ...
(Date:10/13/2017)... ... October 13, 2017 , ... Coveros, a ... has been awarded a contract by the Center for Medicare and Medicaid Services ... accelerate the enterprise use of Agile methodologies in a consistent and high value ...
Breaking Medicine News(10 mins):
(Date:10/10/2017)... Oct. 10, 2017   West Pharmaceutical Services, Inc. ... for injectable drug administration, today shared the results of ... for improving the intradermal administration of polio vaccines. The ... Summit in May 2017 by Dr. Ondrej Mach ... World Health Organization (WHO), and recently published in the ...
(Date:10/4/2017)... , Oct. 4, 2017 ... single-use, self-contained, illuminating medical devices, today announced regulatory ... Health Surveillance Agency (or Agência Nacional de Vigilância ... first single-use, cordless surgical retractor with integrated LED ... optimal access, illumination and exposure of a tissue ...
(Date:10/2/2017)... , Oct. 2, 2017 The Rebound mobile ... the struggle to reverse the tide of prescription drug addiction. ... regulating their medicine intake and stepping down their dosage in ... to launch in December 2017; the first 100,000 people to ... more at http://www.rebound-solution.com/ ...
Breaking Medicine Technology: