CHICAGOIn HIV-positive patients, antiretroviral
therapy should be started when CD4+ lymphocyte counts drop below 350 cells/mL3,
according to a new study reported at the 8th Conference on Retroviruses and
Jon Kaplan, of the Centers for Disease Control and Prevention,
reported that of 5,110 HIV-positive individuals who started 2- or 3-drug
antiretroviral therapy in 1994 or later, those who began treatment when CD4
counts had dropped below 200 cells/mL3 had a markedly increased risk of death,
whereas survival rates were similar for those who began treatment in the range
of 350 to 500 cells/mL3.
Based on these results, a federal panel, convened by the
Department of Health and Human Services and headed by
Anthony S. Fauci, MD, director of the National Institute of Allergy and
Infectious Diseases, has recommended that treatment start at CD4 counts of 350
cells/mL3 rather than the previously recommended 500 cells/mL3.