How Early Should We Start Treatment?

A phylodynamic analysis of HIV isolates from Detroit metropolitan area men who have sex with men showed that almost half of transmissions occurred within the first year of HIV infection.

Recent data from observational studies and clinical trials have demonstrated the benefits of early antiretroviral therapy (ART) initiation in preventing serious non-AIDS events and HIV transmission between discordant partners. With ART initiation now at higher CD4-cell counts, a greater relative proportion of HIV transmissions will occur at an earlier stage of infection. The potential for transmission is substantial during early HIV infection (EHI) for additional reasons: Viral loads are very elevated then, and the risky behaviors associated with the initial transmission event can persist for some time thereafter. Despite these compelling arguments, debate continues as to whether the modern epidemic is being driven by HIV transmission durin…

Reviewing Author

Vincent C. Marconi, MD

How Early Should We Start Treatment?

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Reviewing Author