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February 09, 2006

Study: Early treatment key to fighting AIDS

A new study by researchers from the Centers for Disease Control and Prevention and the University of Colorado adds more confusion to the question of when HIV-positive people should start antiretroviral therapy. Although most physicians now hold off on prescribing the drugs until their HIV patients have low CD4-cell counts or very high HIV viral loads, the new study says that starting treatment earlier produces better long-term results.

The study showed that AIDS-related deaths, incidence of HIV-related opportunistic infections, and adverse drug-related side effects were all lower in patients who started treatment when their immune systems were still intact.

"Earlier was better in almost everything we looked at," Kenneth Lichtenstein of the University of Colorado told Reuters Health. "If you stayed on treatment and started earlier, you had the best outcomes."

Current guidelines recommend delaying anti-HIV drug treatment until CD4-cell counts drop below 350 cells per milliliter of blood, HIV viral levels climb above 100,000, or both. Many even wait until CD4-cell counts drop below 200, the clinical threshhold for an AIDS diagnosis. The delay is mostly to avoid drug-related toxicities for as long as possible, say researchers. But Lichtenstein’s study of more than 2,300 HIV patients from eight U.S. cities found that those who started antiretroviral therapy with CD4-cell counts above 350 were 60% less likely to experience such toxicity issues as kidney problems and lipoatrophy and 30% less likely to develop peripheral neuropathy as those who started treatment with CD4-cell counts of 200 or lower.

The researchers say their findings show there is no reason to delay starting antiretroviral treatment or to delay being tested for HIV to catch infection in its earliest stages. (Advocate.com)

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