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starting treatment
May 28, 2010

Why are different views on the start of treatment of AIDS and why there is no standard protocol for that? in America different from Europe and then come up in the bottom third world countries where the treatment is started too late majority die before the start of treatment, who should bear the guilt of these innocent people who die because of the conflicting views? And the lack of agreement and commitment to a common protocol?

Response from Dr. McGowan

There are 2 separate issues here. The scientific community are moving toward earlier treatment..and you will see both the US and European guidelines moving in that direction because we have readily available and safer treatments here. That would be the best recommendation. There is a study called START that may ultimately answer your question, but many have already moved to earlier treatment based on the available evidence.

The second point regarding later start in the developing world is a political, economic and resource issue. When resources are scarce or limited (medication and infrastructure to deliver treatment), treatment is directed toward those in most immediate need...those with the more advanced disease who will benefit in real and tangible ways right from the start. It would be great if the money that is "found" to fight wars would be directed to this war.

Thank you for your post, Joe

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