WHEN TO TREAT
ANCHOR LEAD: WHEN SHOULD PEOPLE WHO ARE INFECTED WITH HIV BEGIN TREATMENT? ELIZABETH TRACEY REPORTS
CD4 cells are critical players in immune system function, and are often used as a metric to decide when to begin medications in people who are infected with HIV. Joel Gallant, an HIV expert at Johns Hopkins, describes two recent studies attempting to define when therapy should begin.
GALLANT: There were two papers, one that was published in the Lancet that said we should be starting above a CD4 count of 350 and then one in the New England Journal of Medicine that suggested there was actually a survival benefit starting at CD4 counts above 500. It really makes you wonder whether it’s right to be focusing on CD4 counts at all or whether we should just be treating everybody. This is kind of an unusual disease in that here we have this infectious, transmissible lethal disease for which we have outstanding, lifesaving therapy and we argue over when to treat. I think if it were any other disease we’d just be treating people. :34
Gallant says people who learn they are infected with HIV should learn about their options and weigh them carefully when deciding on when to begin treatment. At Johns Hopkins, I’m Elizabeth Tracey.