Loading...
Initiation of antiretroviral therapy (ART) is usually determined by viral load and CD4-cell count. Opinions about optimal timing, which initially favored early treatment, have swung toward later initiation because of concern about drug toxicity and the emergence of viral resistance. Now, opinions may be swinging back again.
To determine the optimal threshold for initiating ART, researchers analyzed data from the multisite Veterans Aging Cohort Study (5742 HIV-infected patients and 11,484 matched uninfected controls). They developed a computer model incorporating patient age and CD4-cell count at therapy inception, as well as baseline viral load, known drug side effects and toxicities, and the accrual of drug-resistance mutations, to predict …