When to Start Meds -- Study on Long-Term Response

[Buckmark]

Here's an interesting study which investigated long-term response to
treatment with HIV meds.  This study finds that those
who start treatment earlier (i.e. when CD4 counts are higher) achieve
higher CD4 counts during treatment.  Also, the researchers found that
CD4 counts leveled off after about 4 years of treatment.

http://www.medscape.com/viewarticle/551776?src=mp

You might need to be registered user of Medscape to view the
article.  I've found Medscape to be a useful source of information,
even though the quantity (and depth) can sometimes be overwhelming.

It's just another data point, but since several folks here have been
discussing when is the appropriate time to start meds, I thought I'd
post this.

Cheers,

Henry

[Boo Radley]

Henry,

The summary of the article includes key information I had not read before:

"After 6 years of successful antiretroviral therapy, the only patients likely to achieve a low-to-normal CD4-cell count were those who had started treatment with >350 cells/mm3; counts stopped increasing after 4 years, regardless of the baseline count."

If the increase in CD4 counts levels off after four years that's rather important!  If this is accurate the CDC guidelines may need to be changed again and people should start HAART when their CD4 count is in, let's say, the 400-500 range. 

Then again, we don't know what the average minimum CD4 count is for a healthy immune system.  Probably varies somewhat from person to person but most people who have CD4 counts >400 still seem to be in good health.   If the immune system is uncompromised at a count of >400 and after 4 years of HAART one's CD4 count is in the 500 - 600 range, are these counts more likely to lead to future immune problems than counts in the 600 - 800 range?

Thanks for this extremely interesting and informative link!

Boo

[sdcabincrew74]

Since I started at a CD4 of 22 while in the hospital with PCP and MAC, I HIGHLY recommend starting a bit higher than that, in fact, a lot higher than that.....if I could do it again, 300 would be my limit.....things can fall MIGHTY fast after that!

[bimazek]

350 is as long as i would go to wait to start meds, but i have been told never make decision based on one test alone, if i hit like 375 and then 322 only  3 months later i would want one more test,
do they ever go up from rest or low stress??

i have bounced around

592, 502, 444, 515 etc

[Miss Philicia]

Why have my cd4's continued to rise steadily over the span of 14 years then?  Or is this 4-year thingie restricted to one particular course of treatment?  I'm too lazy to click the link.  Maybe I should just STFU and go back to watching porn on the other side of my large monitor.  I love multi-tasking.