Earlier is better for HIV treatment


HIV depletes key immune cells (infected T cell shown above). A new study suggests starting a drug regimen before T cell levels get very low may benefit patients.

NIAID/Flickr (CC BY 2.0)

People infected with HIV benefit from starting a drug regimen early, an international study finds.

HIV depletes immune cells called CD4 T cells. Normally there are 500 to 1,200 of these cells per cubic millimeter of blood. HIV can drive that amount below 350 or 250, levels that have typically marked starting points for treatment. Some evidence had suggested that treating HIV-positive people before those benchmarks could have benefits.

So researchers randomly assigned 4,685 HIV-positive adults with T cell counts exceeding 500 to either start on drugs promptly or wait until their count dipped to 350. After three years, 96 people in the deferred-start group had developed an AIDS-defining condition, a long list that includes infections, cancers and other ailments stemming from weakened immunity. Only 42 of those who started on drugs earlier developed such problems, the scientists report in the Aug. 27 New England Journal of Medicine. The results support an international push toward universal treatment.

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