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Starting HIV Drugs Earlier May Delay AIDS But Not Death
Date:4/18/2011

By Randy Dotinga
HealthDay Reporter

MONDAY, April 18 (HealthDay News) -- New research suggests that HIV-infected patients are most likely to stay clear of AIDS longer if they start drug therapy when their immune systems are still relatively strong.

However, starting treatment earlier, compared to waiting, didn't affect dying from AIDS.

"There wasn't a clear benefit in terms of preventing death" by prescribing the drugs before some guidelines suggest, said Dr. Keith Henry, director of HIV clinical research at Hennepin County Medical Center in Minneapolis and co-author of a commentary accompanying the study, published in the April 19 edition of Annals of Internal Medicine.

The issue of when to begin drug treatment is a hot topic in the field of AIDS/HIV medicine. If physicians wait to begin treatment, patients can delay the expense -- not to mention the side effects -- of pricey anti-HIV drugs. But such delays may also give the virus a chance to become more powerful and better able to fend off medications.

If they're not treated with drugs, HIV-infected people almost always go on to develop AIDS.

So when should doctors turn to the drugs? In the U.S., guidelines suggest that HIV-infected patients take them when the level of CD4 cells -- an important part of the immune system -- dips below 0.500 X 109 cells per liter (cells/L). In Europe, the guideline number is frequently lower -- meaning a weaker immune system -- at under 0.350 X 109 cells/L.

In the new study, researchers examined how patients did when they began drug therapy with their CD4 cells at a variety of levels.

The study authors examined the medical records of almost 21,000 HIV-infected patients who sought treatment in HIV clinics in Europe and through the Veterans Health Administration system in the United States. The researchers found that the death rate was about the same regardless of whether pat
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