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Delaying HIV Treatment.

New HIV treatment guidelines are on track regarding recommendations to delay initial antiretroviral therapy, new research findings confirm.

The treatment guidelines from the Department of Health and Human Services aim to balance the long-term adverse effects of antiretroviral therapy against the benefits of early viral control. The guidelines advise patients to delay antiretroviral therapy until CD4 counts fall below 350 cells/ mL.

The findings of a study of more than 1,000 patients indicate that CD4 counts may need to dip below 201 cells /[micro]L before highly active antiretroviral therapy (HAART) significantly reduces disease progression.

Dr. Timothy Sterling of Johns Hopkins University, Baltimore, reported at a conference on retroviruses and opportunistic infections that HAART slowed disease progression among patients with baseline CD4 counts of 200 cells/ [micro]L or less, compared with similar patients who did not receive HAART.

But among patients with baseline CD4 counts of 201-350 cells/[micro]L, HAART was not associated with a decreased risk in disease progression.

HAART similarly did not appear to make much of a dent in progression among patients with baseline CD4 counts greater than 350 cells/[micro]L.

The guidelines advise considering treatment in these patients if the plasma viral load of HIV RNA rises to 30,000 copies/mL, as measured by the branched DNA test.
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Author:Kubetin, Sally Koch
Publication:OB GYN News
Date:Apr 1, 2001
Words:217
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