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Author Topic: Delaying ART can negatively impact CD4 Recovery  (Read 472 times)

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Offline Ptrk3

  • Member
  • Posts: 197
Delaying ART can negatively impact CD4 Recovery
« on: November 28, 2014, 10:37:38 AM »
From time to time on these boards, there does seem to be an ongoing back-and-forth of how soon to start ART (though weight-of-evidence seems to indicate starting right away).  The JAMA report linked to below indicates that delaying ART can permanently hinder CD4 recovery, so it is worth a read and should help inform international bodies that delay ART until a certain CD4 "floor" is reached.  Conclusion:  start ART right away.

http://www.sciencedaily.com/releases/2014/11/141124162920.htm

Offline buginme2

  • Member
  • Posts: 3,303
Re: Delaying ART can negatively impact CD4 Recovery
« Reply #1 on: November 28, 2014, 10:50:07 AM »
Is anyone still advocating for delaying treatment? 

I think this topic has been settle hasn't it.  Is there anyone still waiting to start treatment?

Don't be fancy, just get dancey

Offline Almost2late

  • Member
  • Posts: 490
  • "The Nutcracker"
Re: Delaying ART can negatively impact CD4 Recovery
« Reply #2 on: November 28, 2014, 10:55:02 AM »
I think in the US it's now practice to start right away but not so in other parts of the world...

Wish I could go back in time, if I could I'd not only test once a year but have gone on meds so much sooner..
"Every man has his own destiny: the only imperative is to follow it, to accept it, no matter where it leads him." - Henry Miller

http://www.youtube.com/watch?v=ZBkwPYq4nhQ

“Nothing in the world can one imagine beforehand, not the least thing, everything is made up of so many unique particulars that cannot be forseen.” - Nostradamus

Offline leatherman

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  • Posts: 6,341
  • Google and HIV meds are Your Friends
Re: Delaying ART can negatively impact CD4 Recovery
« Reply #3 on: November 28, 2014, 11:23:29 AM »
sadly though only about 30% of those in the US are retained in care, on meds, and virally suppressed. So while the optimal treatment recommendation may be that everyone diagnosed should be on meds, we're still left with 70% of those with HIV in America having the problems of access to care and adherence to the meds.
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline bocker3

  • Member
  • Posts: 3,459
  • You gotta enjoy life......
Re: Delaying ART can negatively impact CD4 Recovery
« Reply #4 on: November 29, 2014, 06:13:37 PM »
sadly though only about 30% of those in the US are retained in care, on meds, and virally suppressed. So while the optimal treatment recommendation may be that everyone diagnosed should be on meds, we're still left with 70% of those with HIV in America having the problems of access to care and adherence to the meds.

While I agree with your overall sentiment (access and adherence are problems), not all of that 70% are due to this.  We have folks right in these forums who choose to not be on meds.  Granted, not as many as we used to have, but there are still folks out there, who know they are poz, have access to health care, yet choose to remain off treatment. 

I often get taken to task for sitting on a fence -- but here is a great example where things aren't really black and white.  Giving everyone access will NOT result in everyone following recommendations.  The world is far more grey than many like to believe.

This whole recent "study" saying only 3 in 10 are virally suppressed is also being misstated -- as that 10 includes 2 who don't even know they are positive - so of those who know, it is 3 in 8 who are virally suppressed.  While this is still woefully low, it better reflects the reality - you can't be virally suppressed, if you don't know you have the virus in the first place.  Of course, those 2 who don't know are another problem -- we need people to test regularly.

When you layer all the issues together you can see how much more difficult it is to get where we'd like to be than a simple sound bite can portray.

Mike
Atripla - Started 12/05
Reyataz/Norvir - Added 6/06
Labs - Pre-Meds
Sep05 T=350/25% VL98,559
Nov05 288/18%  47,564
Current Labs
May2013 691/31% <20

 


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