The sooner the better when it comes to HIV/AIDS treatment

Oct 27 2008

New research into HIV/AIDS therapy has found that starting treatment with drugs for the AIDS virus may be better sooner than later as victims are more than 70% less likely to die when they started taking cocktails of HIV drugs earlier than currently recommended.

While there is at present no cure for the human immunodeficiency virus (HIV) that causes AIDS, combinations of drugs are able to stop the virus from replicating and damaging the immune system.

In the past it has been unclear when is the best time for patients to begin to take the drug combo regimen and it is common practice for doctors wait for some evidence to appear of damage, by counting the number of immune cells called CD4 T-cells - when patients have fewer than 350 CD4 cells per milliliter of blood, current guidelines advise highly active antiretroviral therapy, or HAART, should commence.

These powerful drug combinations which been available since the mid-1990s have transformed HIV infection from a virtual death sentence to a manageable chronic condition but they do have side-effects including heart and cholesterol problems, diarrhea, nausea and other side effects, which is why treatment was delayed - they also must be taken religiously or resistance develops and the drugs stop working.

The researchers from the U.S. and Canada examined information in International Epidemiology Databases to Evaluate AIDS, a global network of HIV clinics from 1996 to 2006 and compared the records of 8,374 healthy HIV patients with CD4 counts of 351 to 500 who had never taken HAART.

The researchers led by Dr. Mari Kitahata of the University of Washington in Seattle found that during the period studied, 30% of the patients started HAART while the others waited until their CD4 counts fell below 350 and those who waited were 71% more likely to die of something than those who took the drugs early.

Other recently released research has found that patients infected with HIV who interrupt their HAART therapy are more likely to die of heart attacks, strokes and other deadly blood clots.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, which helped fund the study, says the risk of death appears to be higher if you wait than if you treat and the results could prompt doctors to change practice and advise thousands who are not taking AIDS drugs, to start.

Dr. Daniel Kuritzkes, an AIDS specialist at Brigham and Women's Hospital in Boston says the new study shows how important it is to test and diagnose people sooner - he says people are still being tested and identified far too late.

In recent years newer drug combos have meant fewer side effects and some need only a pill or two a day, making the therapy more likely to be adhered to and Dr. Fauci says these advances and the new research justify a fresh look at the guidelines.

According to the U.S. Centers for Disease Control and Prevention (CDC) an estimated 33 million people globally are infected with the AIDS virus but one in five do not know it, which means they cannot be treated.

The researchers presented their findings at a joint meeting of the American Society of Microbiology and the Infectious Diseases Society of America.