New evidence-based consensus: Start HIV treatment at diagnosis
- The Stategic Timing of Antiretroviral Treatment (START) trial was designed to determine the best time to start HIV treatment. It followed 4,685 HIV-infected men and women in 35 coutries.
- In the trial, newly diagnosed HIV patients who staredt treatment immediately were 53% less likely to develop AIDS or die.
- While many experts have always suggested immediate treatment upon HIV diagnosis, in actual practice many patients don't start treatment until symptoms emerge.
In light of the definitive evidence from the START trial, HIV-infected individuals are undertreated. Of the 35 million HIV-infected people in the world, fewer than 14 million are being treated, according to an article in The New York Times. And in the U.S., only about 450,000 HIV-infected individuals are being treated---out of a total infected population of roughly 1.2 million people.
Clearly there are a number of financial barriers, especially in low- and middle-income countries, that interfere with a 100% treatment goal, but the new evidence is likely to push the treatment trend towards earlier treatment, especially in the U.S. Currently, only 37% of HIV-infected Americans have prescriptions for HIV medications---despite the fact that the CDC recommends immediate treatment.
Numerous factors affect guidelines, including taking into the consideration the cost of medications and patient access. Regardless, this new data will most likely influence physician behavior, increase uptake and lead to healthier outcomes in HIV-infected individuals.
- The New York Times H.I.V. treatment should start at diagnosis, U.S. health officials say