Starting combination antiretroviral therapy (ART) at the threshold of 500 CD4 cells/microliter, rather than at 350 or lower, significantly reduces HIV patients' risk of progressing to AIDS, a new study shows.
US recommendations indicate treatment at the 500-cell point for asymptomatic HIV patients, while European and World Health Organization guidelines call for treatment at the 350-cell level. The authors of the current study -- Dr. Lauren E. Cain, with the Harvard School of Public Health, and colleagues -- said information from randomized trials is inadequate to decide between the two approaches, and two large observational studies have yielded conflicting results.
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