14 April 2009

Treat HIV earlier: experts

Patients should start taking drugs for the Aids virus earlier to have the best chance of survival, researchers say.


Patients should start taking drugs for the Aids virus earlier to have the best chance of survival, researchers say.

An analysis of more than 45 000 people with HIV in Europe and North America found they were 28 percent more likely to develop full-blown Aids or die if they deferred treatment until the point currently recommended in many countries.

There is no cure for the human immunodeficiency virus (HIV) that causes Aids, but combinations of drugs can keep the virus from replicating and damaging the immune system.

Doctors normally don't start treatment until there is some evidence of damage to this system, measured by counting the number of immune cells called CD4 T-cells.

Current guidelines
Current guidelines in most countries call for treatment only after the CD4 count falls below 350 cells per microlitre of blood.

In the South African public health system treatment is only initiated at counts of 200 cells or lower.

Jonathan Sterne from Britain's University of Bristol and colleagues found waiting until the CD4 had fallen to 251-350 was associated with a significantly worse outcome than starting therapy in the range 351-450.

The team - whose findings were published online by The Lancet journal - concluded that a count of 350 cells should be the minimum threshold for starting treatment.

“While some researchers say that our antiretroviral treatment programme is sub-optimal because we should be starting people on treatment when their CD4 count is 350 not 200, this has enabled us to put almost 700 000 people on treatment in five years,” health minister Barbara Hogan was recently quoted as saying by Health-E.

A balancing act
Deciding when to start taking Aids drugs has traditionally been seen as a balancing act, since the powerful medicines can have serious side effects and there is also a risk of developing resistance.

Researchers said these problems were now easier to deal with, thanks to the advent of a wider range of drugs, and medics should therefore focus on getting patients onto therapy early.

"It is important that people at possible risk of having HIV get tested regularly so that, if found to be infected, they can receive the necessary care and treatment," they said.

An estimated 33 million people globally are infected with the Aids virus. – (Reuters Health, April 2009)

Read more:
HIV/Aids Centre
Early HIV treatment best

Read Health24’s Comments Policy

Comment on this story
Comments have been closed for this article.

Ask the Expert

HIV/Aids expert

Dr Sindisiwe van Zyl qualified at the University of Pretoria before working for an HIV/AIDS NPO in Soweto for many years. She was named one of the Mail & Guardian's Top 200 Young South Africans in 2012.

Still have a question?

Get free advice from our panel of experts

The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical exmanication, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.

* You must accept our condition

Forum Rules