New study finds no additional health benefits with early HIV treatment

A new study has found that starting anti-retroviral treatment (ART) when an HIV-positive person’s immune system remains generally healthy has very little benefit for that person.

The study found that initiation of such treatment while the CD4 cells — a type of blood cell the virus invades and takes over as a viral factory — are in a slightly normal state had no impact on development of AIDS-associated illnesses. A normal count for CD4s is 800 to 1200 cells per milliliter of blood. The study reviewed cohorts of persons in the following CD4 count ranges: 500-799, 350-499, 200-349 and 50-199. Any measure under 200 is an AIDS-defining clinical measure, according to the CDC definition.

Published in the September 26 issue of the Archives of Internal Medicine, the study found that starting medications prevented development of AIDS in the following measures, reports the closed MedScape.net publication:

The authors found that patients who started HAART with CD4 cell counts from 0 to 49/μL were 68% less likely to die or develop AIDS. The advantage decreased to 52% in patients who started HARRT when their cell counts were from 50 to 199/μL, 41% in patients with cell counts from 200 to 349/μL, 25% in patients with cell counts from 350 to 499/μL, and −10% in patients with cell counts from 500 to 799/μL.

This finding could undermine “test and treat” initiatives being pushed by the Centers for Disease Control and Prevention in Atlanta. The program is an intensive program driven to uncover unknown HIV infections, then get people onto treatment in order to lower the community viral load. Lowering the viral load in the community, it is thought, will reduce the incidence of new infections. The CDC and other public health entities have argued that the decreased community viral load is a positive side effect of better health outcomes for persons starting medications, regardless of the condition of their immune system’s condition at the time of diagnosis.