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Treatment delays are common—and costly - HIV Digest - when to begin antiviral treatment for HIV patients - Brief Article

Men's Fitness, June, 2002

"Two out of every five Americans with HIV begin treatment later than the point which is currently recommended in federal guidelines," says Harold Jaffe, M.D., director of the AIDS program for the federal Centers for Disease Control and Prevention. "We have more people living with HIV in this country than ever before, but we have an unacceptable number of people not receiving treatment or prevention services."

That statistic, covering the years 1996 to 2000, is part of a report presented at the Ninth Conference on Retroviruses and Opportunistic Infections in Seattle.

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Current guidelines suggest that people with HIV begin taking three or more anti-retroviral drugs when their CD4 cell count falls below 350. (The normal level is about 800.) In a University of Washington study also presented at the conference, researchers found that asymptomatic patients who began antiretroviral treatment in their first year of infection, regardless of CD4 levels, had less than half the risk of dying or developing an AIDS complication as those who delayed treatment.

It is unclear whether patients are getting tested later or delaying treatment, but certain demographic groups are more at risk than others. "Late treatment is particularly a problem for the non-white population, for injecting drug users and for people infected heterosexually," says Jaffe. "This may be the result of delayed diagnosis of their infection, delayed treatment, or both." Gay men and non-drug users have a better response record, while women and patients under age 25 are the most likely to seek care in a timely manner.

Approximately 670,000 Americans have been diagnosed with HIV, according to the report, but an additional 180,000 to 280,000 have the virus and don't know it. Of those who are aware that they are HIV-positive, nearly 35 percent are going untreated. These numbers are actually an improvement over earlier statistics. A national study in 1996 found that only half of those who knew they were infected were receiving care.

Treatment delays are common—and costly - HIV Digest - when to begin antiviral treatment for HIV patients - Brief Article

Men's Fitness, June, 2002

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