Word: hiv
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...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...
...Answering that question won't be easy. While there are clear benefits to starting anti-HIV medicines early in the progression of the disease, the drugs are not without side effects. Some studies have noted increased risk of certain cancers as well as toxic effects to the brain and other organs over the long term. "The real critical issue that everyone is struggling with is, What about the potential long-term deleterious effects of ART that might override the beneficial effects?" says Fauci...