May 2006
Early Birds
by Tim Murphy
Starting treatment sooner may control HIV—and side effects
Federal treatment guidelines and many doctors argue that because HIV meds can cause troubling side effects, you shouldn’t consider starting them until your CD4s hit 250. But a massive ten-year HIV study unveiled in February at the big Denver AIDS conference suggests otherwise.
It found that, among 2,222 positive people, those who started meds with 350 or more CD4s and stuck to their regimens had not only higher CD4 counts and lower viral loads than those who started at 200 or lower, but they also had fewer side effects, specifically kidney pro-blems, neuropathy and lipoatrophy (fat loss).
Study leader Kenneth Lichtenstein, MD, of the University of Colorado, says that’s because untreated, HIV reproduces actively, triggering overactivity in the immune system and spurring cell inflammation. That, in turn, promotes higher levels of HIV meds inside cells once treatment begins—causing more intense side effects.
