Continuing the conversation about more effective use of the newer medications to improve efficacy and decrease toxicity in HIV patients.
The IAS-USA Treatment Guidelines were released during the conference, supporting earlier initiation of treatment with ART recommended for all patients with CD4 counts < 500, selected clinical conditions, and all symptomatic patients (provided patients are ready to start therapy: “The patient must be ready and willing to adhere to lifelong therapy,” the document explicitly states. Additional populations for ART initiation included pregnant women, and those with acute primary infections. The document is well worth a good read for its careful review of the data behind the pendulum swinging to earlier initiation in 2010.
Bottom line: HIV probably does increase risk but not as much as some of the more traditional modifiable risk factors (like smoking). Hopefully, in the future the START study results whether treatment practices should be changed. .