Experts recommend early treatment therapy for HIV patients

A clinical trial from Haiti comparing the outcome between earlier therapy and deferred therapy found that the former course of action reduced fatalities by 75 percent and the rate of new infections by nearly half.

According to experts, "The prominence of non-AIDS events as a major cause of morbidity and mortality in those with ongoing HIV replication suggests that early ART initiation may further improve the quality and length of life for persons living with HIV.”

New guidelines issued
A panel of eminent scientists at the International AIDS Conference in Vienna revised the treatment cut-off to CD4 count of 350 cells per cubic millimeter--a measure of the body’s immune system.

The earlier status was to start treatment after the count fell below 200 CD4 when symptoms of AIDS and related infection surfaced.

The current recommendations suggest treatment should start at CD4 count of 500 cells or less for people with no symptoms and in those exhibiting obvious signs treatment should be initiated irrespective of CD4 count.

Melanie Thompson of AIDS Research Consortium of Atlanta and chairperson of the US branch of the International AIDS Society stated, “There is no CD4 cell count threshold at which initiating therapy is contra-indicated (not advised).”

Treatment procedure recommended
According to scientists, in the initial stages of the infection when the immune system is strong, this therapy can slow the progression of HIV/AIDS symptoms and cut viral loads in the plasma.

They recommend a treatment regimen comprising of at least two or three drugs in fixed-dose combinations.

To begin with, a combination of tenofovir plus emtricitabine with efavirenz, atazanavir, darunavir or raltegravir as the third component would be ideal.

In addition, blood virus levels should be monitored closely after the onset of treatment and medicines altered if viral load increases or CD4 counts fall.

Immediate treatment is recommended for pregnant patients, those 60 and older, patients infected with hepatitis B or C, and those with underlying health issues such as kidney disease and cardiovascular problems.

Treatment should be stopped only for clinical trials.

More than 33 million people are infected with HIV/AIDS worldwide with nearly 25 million succumbing to the deadly disease since it was first identified in 1981.

The panel members wrote, "Far too many HIV-infected persons present for medical care with advanced disease, both in wealthy and resource-limited settings.

"Advances [in antiretroviral therapy] have shown that AIDS, as traditionally defined, can be prevented."

The new guidelines will be published in the July 21 HIV/AIDS theme issue of the Journal of the American Medical Association.