An ongoing dialogue on HIV/AIDS, infectious diseases,
2 Responses to “WHO HIV Treatment Guidelines Updated”
Paul E. Sax, MD
Associate Editor
NEJM Clinician
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Should the guidelines have suggested initiation at < 500 as is expected in the next iteration of US centered guidelines? Although ARVs are limited in many parts of the world should an individual patient be witheld therapy when there is an accumulation of data suggesting 500 (or higher) may be the tipping point? A conundrum in areas where supplies of ARVs are limited perhaps.
CM,
I guess one way of looking at “start at CD4 350” is “start at CD4 > 350.” I realize it’s not exactly the same thing, but since you can’t predict when or if the CD4 will drop, as a pt approaches this threshold (i.e., between 350 and 500), it’s time to get ready to start.
As you know, DHHS guidelines just out as well.
Paul