Early AIDS Treatment Saves Lives, Money

Deaths reduced by 75%, study finds

21 July 2010

A new study shows beginning AIDS treatment earlier can save lives.

A new study of HIV-infected people in Haiti indicates that starting treatment early could save many patients who might otherwise die of AIDS. And starting anti-AIDS medicines earlier might also save money.

The World Health Organization currently recommends that patients begin taking AIDS medicines, called antiretroviral drugs, when symptoms appear or when their CD4 count drops below 200.

The count measures immune cells that are killed off by the AIDS virus, HIV.

Beginning treatment when CD4 drops to 200 works well, but a team of Haitian and American doctors at the GHESKIO clinic in Port-au-Prince wanted to see if they could do better.

In the study, patients were randomly assigned either to get AIDS medicines when their CD4 count hit 200, the standard procedure, or to get the antiretrovirals earlier, when their CD4 had only dropped to 350.

Researcher Daniel Fitzgerald explains that "the results of the trial showed that the rate of mortality was cut by 75 percent if antiretroviral drugs were started earlier. And also that the rates of tuberculosis" — a common side-effect of HIV infection — "that those rates were cut in half by starting earlier."

Fitzgerald says his randomized study provides additional support for previous studies that suggested doctors are sometimes waiting too long before beginning treatment for HIV-infected patients.