A Lingering, Unanswered Question

First, there was 'hit early, hit hard.' Then there was delaying therapy as long as possible to avoid drug side effects. Next came starting treatment when CD4-cell counts decline to 350 cells. And now suggestions are again emerging to start treatment earlier. So, which approach is right? No one is really sure, and two new studies only add to the ongoing confusion. A Canadian study presented at the 48th Interscience Conference on Antimicrobial Agents and Chemotherapy shows that HIVers who start therapy with a CD4-cell count between 350 and 500 had a 71% lower risk of death, and those starting treatment above 500 cells ultimately achieved the highest CD4-cell rebounds. But a competing study of 21,000 HIVers reported at the 16th Conference on Retroviruses and Opportunistic Infections showed that those who start therapy later have the same outcomes once their CD4-cell levels rise above 400 as do those who initiate treatment earlier. The debate -- and the research -- continues'