Early HIV Treatment Shows 70% Improvement in Survival

By Anna Boyd
15:59, October 27th 2008
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Early HIV Treatment Shows 70% Improvement in Survival

HIV patients who began treatment earlier than is currently recommended lived longer compared to those who followed guidelines, US and Canadian researchers found.

HIV virus ravages the immune system’s T-cells that fight off germs. Once this process begins, people are vulnerable to a series of diseases that can be fatal. Current guidelines by the government and the International AIDS Society recommend that patients who are not yet having AIDS symptoms delay starting on retroviral drugs until their T-cell count falls below 350 per cubic millimeter of blood. Healthy people have more than 800. The recommendation was given as retroviral drugs can cause heart and cholesterol problems, diarrhea, nausea and other side effects.

"There was this thinking, maybe the drugs were worse than the disease. If you could wait as long as you possibly could wait, you would have fewer side effects," said Dr. Robert Schooley, infectious diseases chief at the University of California, San Diego.

Now, the new study questions the current guidelines as it found that the earlier treatment starts, the better.

"The data are rather compelling that the risk of death appears to be higher if you wait than if you treat," said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, which helped pay for the study.

US and Canadian researchers led by Dr. Mari Kitahata of the University of Washington in Seattle analyzed information on 8,374 people in the United States and Canada with T-cell counts of 351 to 500 from 1996 to 2006.

During the study, 30 percent of the participants started taking AIDS drugs right away, while the rest followed current guidelines, waiting for their T-cell counts to fall below 350.

"We found a 70 percent improvement in survival for patients who initiated therapy between 350 and 500" compared to those who followed the guidelines, Kitahata said.

Since 1996 when retroviral drugs were introduced, the average life expectancy of 20-year-old HIV patients has risen about 13 years, a study in the journal Lancet said in July.

Another study released earlier this month showed that HIV patients taking breaks from their treatment are more likely to die of heart attacks, strokes and other deadly blood clots.

The study was reported Sunday at a joint meeting of the American Society of Microbiology and the Infectious Diseases Society of America in Washington.

The US Centers for Disease Control and Prevention reported that more people are becoming infected each year than previously estimated, with 56,300 new HIV infections in the US in 2006. Previous estimates put the number of new infections at about 40,000 a year.

Blacks account for about 46 percent of cases. About 1.7 percent of U.S. blacks are infected, compared with 0.6 percent of Hispanics and 0.2 percent of whites. Gay men represent 48 percent of those living with HIV.

Other findings reveal that 28 percent of Americans living with HIV are heterosexual, 72 of American women with HIV and 13 percent of American men with HIV were infected via heterosexual intercourse and 19 percent of Americans living with HIV were infected via injection drug use.



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