The “When to Start ART” Debate: More Data in Favor of Earlier Treatment

Patients starting antiretroviral therapy in Africa had a much better chance of survival if their on-treatment CD4 count reached >500 cells/mm³.

In developed countries, HIV-positive patients on antiretroviral therapy (ART) who survive the first 6 months of treatment may have a life expectancy similar to that of their HIV-negative peers, particularly if their CD4 counts rise above 500 cells/mm³ during treatment. However, in resource-constrained settings, limited data are available on long-term mortality in patients receiving ART.

To address this issue, researchers reviewed data from 27,018 patients in Africa who had been receiving initial ART free of charge for at least 9 months (median pre-ART CD4 count, 152 cells/mm³; 68% women). During a median follow-up of 3.3 years, 2.4% of patients died and 10.3% were lost to follow-up.

Overall mortality rates declined substantially with longer d…

Reviewing Author

Mauro Schechter, MD, PhD

The “When to Start ART” Debate: More Data in Favor of Earlier Treatment

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Reviewing Author