Should antiretroviral therapy be started earlier?
Current treatment guidelines recommend that antiretroviral therapy be deferred until the CD4 count has fallen into the 200 to 350 cells/mm(3) range. However, treatment has become simpler, less toxic, and more forgiving of missed doses. Longer-term follow-up data from clinical cohorts are now showing better outcomes when therapy is started at higher CD4 cell counts. Therapy initiated early has better virologic and immunologic responses, is better tolerated, and is cost-effective. Recent developments and clinical data support a return to earlier initiation of therapy.
Gallant
Joel E
JE
Division of Infectious Diseases, Johns Hopkins University School of Medicine, 1830 East Monument Street, Room 443, Baltimore, MD 21205, USA. jgallant@jhmi.edu
D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy* / Q000821:virology; D006505:Hepatitis / Q000188:drug therapy / Q000821:virology; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D013995:Time
D044966:Anti-Retroviral Agents