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

ients 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


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