Early antiretroviral for HIV extends life expectancy

[Jmarksto]

I don't think this study has been discussed here.  I know there are folks that want to know when to start meds - this may help with that decision.

http://ow.ly/vMqos

People who initiated cART treatment early—when their CD4 counts were in the 350-to-500 range—could expect to live 6.1 years longer than persons with late cART initiation, which was defined as cART not administered until the CD4 count fell below 350.

The survival benefit was even greater for the earliest initiators of cART: Persons who began such treatment while their CD4 counts were higher than 500 could expect an additional 9.0 years of life.

[Jmarksto]

...that URL may not be working, here it is again:

http://tinyurl.com/lts37me

[buginme2]

People will still come up with excuses for not starting.

Anyway, I read an article yesterday on aidsmap.com and there was a mention that it is expected that global recommendations will be changed to "treatment upon diagnosis."  I thought that was bold since most of the planet is still using 350 as the magic number.   

That got me thinking how the boys will react.  Being told to start meds asap regardless. 

[AusShep]

People will still come up with excuses for not starting.

Anyway, I read an article yesterday on aidsmap.com and there was a mention that it is expected that global recommendations will be changed to "treatment upon diagnosis."  I thought that was bold since most of the planet is still using 350 as the magic number.   

That got me thinking how the boys will react.  Being told to start meds asap regardless.

Yeah, I think the trend has been showing for a long time that the earlier the better.  Whether it's because of reservoirs, long term immune activation, inflammation, or something else, who knows...  Even the stickied discussion on when to start treatment was before additional research came out showing improved morbidity/mortality numbers for starting above 500.

[friskyguy]

Yeah, I think the trend has been showing for a long time that the earlier the better.  Whether it's because of reservoirs, long term immune activation, inflammation, or something else, who knows... 

yes I agree........and the one thing that will ultimately drive policy makers recommending 'treatment upon diagnosis' will be the confirmation that treatment prevents the HIV spread.......as is what we are seeing from the latest "Partner" ongoing study.

Once that study is finalised and final results hopefully confirmed that being on successful treatment effectively prevents the spreading of HIV infection, and the realisation and trump card for the economic boffins to find budget support for treatment upon diagnosis due to being more cost effective in the long run.

This will be more than likely to be accompanied with a big government push to get all HIV infected to get on subsidised treatment accompanied by free HIV testing (well in those countries that provide socialised medicine....which are the majority of developed world countries anyway, except for one large notable exception).

There is even some talk now that certain HIV susceptible groups, ie MSM, should be more of a prioritised target for this early bird approach which could see this scourge effectively minimised (within one or two generations in developed countries that would implement such a country approach).

With a cure continuing to be allusive those of us with the virus on effective treatment will just die off gracefully and disappear into the sunset.

[xinyuan]

I'm not surprised with this study.

The benefit in life expectancy is not only due to suppressing the virus itself.

It is also due to advances and improvements in the available drug regimens. Newer agents have less side effects - both short-term and long-term. Of course, we may discover other long-term ones. The risks are decreasing relative to the benefits.


But let me be clear. At least we CAN be around to face them.


The alternative is succumbing to OI's in the short-term or upping the risk of HIV-associated cancers or other diseases in the long-term. Or dying sooner. Because therapy was delayed.


I can never fully understand the trials that long-term survivors faced and are facing with earlier ART's. Back then, the "cure" realy was worse than the disease.

I equally fail to understand the strong resistance that many people have with starting ART's earlier in this era. Please keep in mind that being on therapy is a life-long committment.

Everyone gets so hung up on risks of therapies, each person forgets the bigger picture:

You have to weigh your risks AND benefits AND alternatives.