CDC Supports Starting HAART Early

A new study by scientists at the federal Centers for Disease Control and Prevention supports U.S. guidelines that call for anti-HIV drugs to begin before serious immune system damage occurs. The study, published in the September online edition of Clinical Infectious Diseases, tested'and rejected'the theory that HIV-positive adults respond satisfactorily to HAART regardless of the CD4-cell count at the time therapy is started. Clinical data from 2,729 participants in the CDC's 11-city Adult and Adolescent Spectrum of HIV Disease Project showed that those with the lowest CD4 counts when starting antiretroviral drugs were at the highest risk of progressing to an AIDS diagnosis or death. The worst prognosis was in patients who started HAART with less than 200 CD4 cells; the best was recorded in people with CD4 counts above 500. Viral load measurements also played a significant role in disease progression, according to the study. Patients with CD4 counts between 200 and 350 typically had a low risk of HIV complications or death if they also maintained low viral loads; those in that CD4 range with high viral loads were at an increased risk of illness, though not as high a risk as patients with fewer CD4 cells.