What a difference a year can make. According to data from the U.S. Military HIV Natural History Study, people who started HIV meds 12 months or more after becoming HIV positive (rather than closer to the time of infection) had a much harder time reaching a "normal" CD4 count. A CD4 count measures how many of that type of illness-fighting immune system cells are in one microliter of blood. The study used 900 as the average normal CD4 count, and found that those who delayed use of HIV meds had an 80% lower chance of reaching that number -- which meant a reduced chance of having a fully functioning immune system.
The U.S. Centers for Disease Control and Prevention (CDC) guidelines now recommend that everyone who is newly diagnosed go on HIV medications, regardless of their CD4 count at the time of their diagnosis. Previous CDC guidelines recommended a person wait until a certain CD4 threshold had been reached. However, for those in this study, it was the amount of time since infection and the initiation of treatment (not the CD4 count when meds were started) that was the greatest indicator of medical success.
Among those newly beginning HIV meds, the study found that 38% who started meds within 12 months of becoming positive were able to reach a CD4 count of 900, compared to only 28% of those who started after 12 months.
The study also found that people who started HIV meds within 12 months of becoming positive had a significantly lower chance of developing AIDS than those who waited (8% versus 15%).
Since the CDC guidelines state that starting therapy right away is the best option for all newly diagnosed individuals, why would people wait to start therapy? Well, for one, they might not know they have HIV. It is estimated by the CDC that approximately 14% of people living with HIV in the U.S. do not know that they have it.
The researchers concluded that it is important to start HIV medications as close to the time of infection as possible. However, they had very little to say about testing, as a key step in that equation. Current guidelines recommend that everyone age 13 to 64 get tested for HIV as part of routine clinical care, or at least once a year -- especially if they share injecting equipment, have a history of sexually transmitted infections or have unprotected sex with multiple or anonymous partners. But the guidelines note that some providers recommend HIV testing every three to six months for people who fall into these kinds of risk categories. For a guide on HIV testing, check out AIDS.gov.
To read the study results in full, head over to the International AIDS Society.
Mathew Rodriguez is the community editor for TheBody.com and TheBodyPRO.com.
Follow Mathew on Twitter: @mathewrodriguez.