New trial to determine if better to start treatment earlier

An international trial that has just started enrolling [1]The act of signing up participants into a study. Generally this process involves evaluating a participant with respect to the eligibility criteria of the study and going through the informed consent process. in Australia aims to determine whether it is better to start treatment earlier, when T-cell counts are above 500, or when they drop to 350 as per the current recommendations.

With certain exceptions, treating earlier than the 350 mark is not currently recommended for a number of reasons. Taking pills for longer may mean more side effects. It’s more likely you’ll get tired of taking pills, miss doses and develop resistance [2]HIV which has mutated and is less susceptible to the effects of one or more anti-HIV drugs is said to be resistant.. It’s more expensive.

However, there’s data to suggest that treating earlier is better. Recent studies compared treaters with non-treaters at identical cell counts and found that the risk of developing AIDS-defining conditions were higher for the non-treaters, even when their counts were well above 500 cells/mm3.

Those not on treatment developed cancer and other illnesses affecting the heart, liver [3]A large organ, located in the upper right abdomen, which assists in digestion by metabolising carbohydrates, fats and proteins, stores vitamins and minerals, produces amino acids, bile and cholesterol, and removes toxins from the blood., or kidneys at higher rates than usual even at higher CD4+ cell counts.

On the other hand some HIV treatments are associated with an increased
risk of some problems including heart attacks.

There are pros and cons on both sides. This five-year study is an important step towards finding where the balance lies.