Quantifying the Benefits of Early ART Initiation

Mathematical modeling suggests that starting ART at CD4 counts >500 cells/mm³ offers limited clinical benefit over starting at CD4 counts >350 cells/mm³, but the jury is still out.

Although treatment guidelines advocate initiating antiretroviral therapy (ART) early, the immunologic and clinical benefits of starting ART at high CD4-cell counts remain ill-defined. To address this issue, researchers evaluated observational data from a cohort of 432 Australian patients who initiated ART at CD4 counts >350 cells/mm³.

Immunologic response to therapy was largely predicted by baseline CD4-cell count, time since initiation of ART, and the interaction between these two variables. After 12 months of therapy, the proportion of patients with CD4 counts >500 cells/mm³ was 64% among those who had started ART at 351–500 cells/mm³, 84% among those who had started at 501–650 cells/mm³, and 93% among those who had started at >650 cells/m…

Reviewing Authors

Arash Poursina, MD

Helmut Albrecht, MD

Disclosures

Grant / Research supportHealth Resources and Services Administration; Centers for Disease Control and Prevention

Leadership positions in professional societiesColumbia Medical Society; South Carolina Infectious Diseases Society

Helmut Albrecht, MD

Disclosures

Grant / Research supportHealth Resources and Services Administration; Centers for Disease Control and Prevention

Leadership positions in professional societiesColumbia Medical Society; South Carolina Infectious Diseases Society

Quantifying the Benefits of Early ART Initiation

Topics

Reviewing Authors