The battle over when to intervene with protease cocktails has now taken center stage in the AIDS community. After intense wrangling by a scientist-dominated panel, federal antiretroviral guidelines say full-gun, three-drug treatment should be offered once a person with HIV has a viral load of at least 10,000 or less than 500 CD4 cells. Activists complained bitterly that only their threats to quit the panel blocked attempts by many scientific panelists to vastly extend -- without any data -- the "hit early" call. Some physicians and PWAs think even the guidelines adopted urge too much, too soon. They fear starting these hard-to-manage regimens early may eventually provoke dangerous viral resistance and/or debilitating toxicity. So while every HIV positive person should have the right to opt for -- and get coverage of -- any drug at any infection stage, extreme caution and diverse opinions are always in order when making momentous treatment decisions.
Trick or Treat?