Earlier HIV treatment can save more lives
Moving up the starting point for HIV treatment leads to improved survival rates
WASHINGTON — Treating HIV earlier can increase a patient’s survival chances, a new study of more than 8,000 HIV patients shows. The findings suggest doctors should rethink the standard practice of HIV treatment, a team reports at a meeting of microbiologists and infectious disease researchers.
HIV depletes key immune cells called CD4 T cells. A patient’s T cell count, the concentration of CD4 cells still in circulation, is used to gauge how far the virus that causes AIDS has progressed and to determine when to treat a patient with the frontline drug cocktail for HIV. The standard benchmark for initiating this treatment has been a T cell count of 200 cells per cubic millimeter of blood.
A new study presented by physician and HIV/AIDS specialist Mari Kitahata of the University of Washington in Seattle suggests that the cut-off point should be placed much sooner, at only 500. This benchmark, presented October 26 in Washington, D.C., during the combined meeting of the Infectious Diseases Society of America and the Interscience Conference on Antimicrobial Agents and Chemotherapy, goes even farther than a recommendation in the Aug. 6 Journal of the American Medical Association to start intensive treatment when the T cell count drops to only 350.
Before newer HIV drugs were on the market, doctors often delayed treatment. This was not only because of cost, but also because of the serious side effects from the drugs available at the time and the fear that patients’ failure to stick to the large and onerous daily drug regimen would create drug-resistant HIV, says physician Daniel Kuritzkes of Brigham and Women’s Hospital in Boston. In recent years, though, newer drugs have become available that require fewer daily doses and have less harmful side effects — leading many doctors to reconsider the threshold for beginning treatment.