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Even in the U.S., many people don’t seek or stick with early care: The Centers for Disease Control and Prevention recently reported that only about 30 percent of Americans with HIV have their virus under control.
The START trial enrolled 4,685 people in 35 countries, all of whom had CD4 counts in the healthy range — above 500 — and had never taken anti-HIV medication. Researchers tracked deaths, the development of AIDS-related illnesses and the development of serious non-AIDS events such as cancer, heart disease and kidney or liver disease.
Over about three years, the risk of serious illness or death was reduced by 53 percent in the early treatment group, NIH said.
The actual numbers of bad outcomes in both groups were very low, given that patients were so healthy when they enrolled in the study: 41 cases in the early-treatment group compared to 86 in the group that delayed treatment until their CD4 count dropped to near 350.
Still, “this is another reason why we should be more aggressive in seeking out voluntary testing” and getting people care, Fauci said. “It tells you that you will benefit from therapy at whatever your CD4 count is.”
Article continues belowThe WHO is expected to reconsider its treatment guidelines soon.
Fauci acknowledged that expanding early treatment would cost more up-front. But he contended that “at the end of the day, there’s no doubt that it’s going to be less expensive to treat people early,” and try to avoid the more expensive care of full-blown AIDS.
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