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Early HIV infection - treatment or no?
Feb 18, 2007

I recently was diagnosed with HIV. The labs done (detuned antibody) indicated infection 3-6 months ago. Is there chance of benefit from going on combination treatment at this time? My CD4 is 510 and VL 13,500. I have seen some articles suggesting there is possibility of preserving some of the immune system at this stage.

Response from Dr. Pierone

Most of the studies of early treatment of HIV infection involve individuals who were diagnosed before, during, or immediately after infection. Some of these trials showed potential benefit from very early treatment. But past a 3 month window there are no convincing data that treatment with higher CD4+ lymphocyte counts is indicated or necessary. In fairness though, we have no evidence that starting antiretroviral therapy with higher CD4+ lymphocyte counts is a bad thing either. There is no question that newer antiretroviral agents are more tolerable and this fact should logically shift the pendulum towards earlier initiation of HAART, although the guidelines have not changed.



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