Study Clarifies When to Start HIV Therapy

CHICAGO—In 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 8^th Conference on Retroviruses and Opportunistic Infections.

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.