DRUGS OR NOT?
ANCHOR LEAD: WHILE DISCUSSION CONTINUES OVER WHEN TO BEGIN ANTIVIRAL THERAPY FOR HIV INFECTION, THERE IS A SOLUTION, ELIZABETH TRACEY REPORTS
Medications to combat HIV infection have historically been associated with a range of side effects, some of them unacceptable to patients. This has caused some to postpone treatment until CD4 cell counts fall. But today’s combinations of drugs can largely avoid many side effects, and there are benefits to early treatment. That’s according to Joel Gallant, an HIV expert at Johns Hopkins.
GALLANT: I’m explaining this all to patients and I’m telling them what the current guidelines say which is that we should start at 350 or below, but I’m pointing out that those guidelines are likely to change, that there’s a rationale for treatment at any stage of disease, and I always hope that patients will ask well what would you do? And if you ask almost any HIV expert what they would do if they were infected they almost all say I would start treatment immediately. Patients should always ask that question of their doctors, what would you do? And I tell them I would start treatment. :25
Gallant recommends prompt initiation of therapy because he says once symptoms, including falling CD4 counts, appear, the disease is well underway. At Johns Hopkins, I’m Elizabeth Tracey.