Word: hiv
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Dates: during 2000-2009
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...defer treatment until their CD4 counts dropped below 500 cells. (In a normal, healthy adult, CD4 levels range from 600 to 1,200.) In both studies, the patients deferring treatment were more likely to have died by the 2005 end of the study than were their earlier-treated cohorts. HIV-positive patients beginning therapy at CD4 levels between 351 and 500 cells were 69% more likely to be alive at the end of the nine-year study, while those initiating drug treatment at CD4 counts of 500 or more were 94% more likely to have survived...
...have a particularly strong view about this," says Ho about the early treatment of HIV, "so these results are what I would expect. You have a virus that is churning away actively, constantly destroying important immune cells, so how can it be good to let that go on unchecked by delaying therapy...
...impressed with the results. "This is a very good study that at least suggests strongly that there is a benefit to starting treatment early," says Dr. Anthony Fauci, director of the National Institute on Allergy and Infectious Diseases. But is it enough to change the current guidelines for when HIV-positive patients should start ART? "That is a question of debate now in the scientific and public-health community," he says...
...fact, when the potent ART combination therapy first emerged in the mid-1990s, government health officials recommended that anyone with a CD4 count of 500 cells or lower receive treatment. But in response to growing concerns over HIV's increasing ability to become resistant to the drugs, as well as worries over the drugs' toxicity and patients' inconsistent compliance with their regimen, the guidelines dropped to 200 before eventually settling at 350 cells - much further along in the progression of the disease...
...Still, Fauci acknowledges that the sheer size of Kitahata's study gives its findings some weight. She presented the preliminary data to a government panel on HIV-treatment guidelines in February, and the results have since gotten HIV experts talking about whether waiting to begin treatment until the current threshold of 350 cells is reached is too late to improve HIV patients' survival...