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It's one of the most confusing and evolving issues in HIV care'when to begin antiretroviral therapy. But a new report in the Journal of the American Medical Association bolsters the emerging standard of beginning therapy when CD4-cell counts drop below 350. The benefits of earlier treatment are lower rates of cardiovascular and kidney disease, liver dysfunction, and incidence of lung, anal, head, and neck cancers, say officials with the U.S. chapter of the International AIDS Society, which presented the new recommendations. And the drawbacks to earlier treatment'medication toxicities and adverse side effects'have decreased with the approval of newer, better-tolerated drugs, the panel says. The report also recommends using recently approved drugs Isentress, Selzentry, and Intelence with older treatments in HIVers experiencing treatment failure on other regimens.
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