Delaying HIV treatment increases risk of mortality

BMJ 2008; 337 doi: (Published 05 November 2008) Cite this as: BMJ 2008;337:a2369
  1. Bob Roehr
  1. 1Washington, DC

    Delaying the start of antiretroviral treatment in people with a CD4 T cell count of between 351 and 500 raises the risk of mortality by 70%, concludes an as yet unpublished analysis of data from 22 HIV cohort studies in the United States and Canada.

    Opinions on when to start treatment for HIV have oscillated between “hit it early, hit it hard”—which came into vogue with the advent of highly active antiretroviral therapy (HAART) in the mid-1990s—and retrenchment to a more cautious approach as the side effects of HAART became more evident.

    The pendulum began to swing back to more aggressive treatment with the approval of newer drugs that were more tolerable and carried fewer long term risks. The findings from this new study are sure to nudge …

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