New studies from the Johns Hopkins Bloomberg School of Public Health and French researchers suggest people infected with HIV may be able to delay taking the triple antiviral drug therapy longer than previously thought without jeopardizing their health. The studies suggest there is little difference in starting treatment when CD4 levels are above 350 and waiting to start treatment when levels drop near 200. Waiting longer may spare an HIV-positive person from a year and a half of taking drugs. Both studies were presented during the XIV International AIDS Conference in Barcelona, Spain, and reported in the July 10 edition of the Washington Post. Using prospectively collected data in the Multicenter AIDS Cohort Study (MACS) and the Women's Interagency HIV Study, Stephen Cole, PhD, assistant research professor of epidemiology in collaboration with Alvaro Munoz, PhD, professor of epidemiology at the School of Public Health, and other colleagues, compared the experiences of people who started triple therapy when their CD4 counts were below 200 to those who began triple therapy with counts between 201 and 350, and between 351 and 500. A normal CD4 count in a non-HIV-positive person is about 1,000.
The results showed almost no differences in the time people stayed healthy and free of AIDS, whether they started antiviral treatment with a count of 201-350 or 351-500. People who waited to begin antiviral treatment with a CD4 count below 200 were adversely affected, but less than in previously reported studies that did not account for issues addressed by methods proposed by the Johns Hopkins investigators. Washington Post Article
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