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More compelling evidence on why earlier HIV treatment lengthens survival
Date:4/2/2009

p>Results from the first analysis were announced Oct. 2008 at the 48th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy/46th Annual IDSA Meeting Washington DC. Among the 8,632 patients with a CD4+ count+ 351 to 500, those who deferred antiretroviral therapy until the CD4+ count was below 350 had an increase of 69% in the risk of death.

Results from the second analysis were announced Feb 2009 at the 16th Annual Conference on Retroviruses and Opportunistic Infections in Montreal, Canada. Among the 9,155 patients with a CD4+ count above 500, those who deferred antiretroviral therapy until the CD4+ count was below 500 had an increase of 94% in the risk of death.

About 1.1 million people in the United States are infected with HIV, the virus that causes AIDS, according the U.S. Centers for Disease Control and Prevention. Worldwide, about 33 million people are infected with HIV, according to UNAIDS.

In the past, recommendations for when to start antiretroviral therapy shifted to waiting until later in HIV disease to lower CD4+ counts because of concern for resistance and toxicities of treatment. New treatments, however, are more potent, have fewer side effects and have to be taken less frequently, said Kitahata.

Additional benefits of earlier therapy for HIV include greater likelihood of achieving a normal CD4+ count and reduction in inflammation and immune activation that result in potentially irreversible immune-system and end-organ damage, such as cardiovascular, liver and renal disease. Results of the study suggest that the side effects of treatment are less deleterious than untreated HIV infection.

The decision to begin antiretroviral therapy is one each individual makes in consultation with their doctor. Kitahata said that If an asymptomatic individual has a CD4+ count greater than 500 and is ready to begin therapy, it should be started in conjunction with ongoing monitoring for potential side e
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Contact: Mari Kitahata, MD, MPH
kitahata@u.washington.edu
206-744-3677
University of Washington - Health Sciences/UW News, Community Relations & Marketing
Source:Eurekalert

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