Earlier HIV Treatment Is Gaining Momentum

Clinicians have long debated the question of when to start antiretroviral therapy (ART) in HIV-infected, asymptomatic patients. Although no definitive answer has emerged, data presented in 2008 provide support for earlier treatment initiation.

Current guidelines from the U.S. Department of Health and Human Services recommend ART for all patients who have CD4 counts <350 cells/mm³ or AIDS-associated morbidity (AIDS Clin Care Nov 6 2008). They also recommend ART, regardless of CD4-cell count, in three select groups of patients: HIV-infected pregnant women, patients with HIV-associated nephropathy, and patients with HIV and hepatitis B virus (HBV) coinfection in whom HBV treatment is indicated. For HIV-infected patients with CD4 counts >350 cel…