During the “Reach for the Top: Can We Perfect Current ART?” abstract session held at the 7th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2013), researchers presented evidence showing that initiating antiretroviral therapy (ART) in chronically HIV-1 infected patients before their CD4+ count falls below 500/mm3
leads to better outcomes.
In their study “In chronically HIV-1-infected patients long-term antiretroviral therapy initiated above 500 CD4/mm3
achieves better HIV-1 reservoirs' depletion and T cell count restoration,” Laurent Hocqueloux, MD, and colleagues looked at a cohort of chronically infected patients patients being treated with efficient cART who had a normal CD4+ T cell count (≥900/mm3
), a normal CD4/CD8 ratio (>1), and a low HIV-DNA level (<2.3 Logcp/106 PBMC) “according to their nadir CD4+ T cell count prior to starting ART.
Patients were stratified according to CD4+ nadir: >500, 350-500, 200-350 and < 200 cells/mm3
. They measured total HIV-DNA in PBMC at least once a year before (when possible) and during treatment. They also measured T-cell count (CD4+, CD8+) and PVL every 3-4 months.