US HIV Treatment Guidelines--Give ARV's Regardless of CD4 Count

From Science Speaks: HIV & TB News, by Meredith Mazzotta

The U.S. Department of Health and Human Services (HHS) released updated HIV treatment guidelines on March 27 which, among other things, maintain that all people living with HIV in the U.S. are now eligible to receive antiretroviral therapy (ART), regardless of CD4 cell count. Previous guidance recommended ART for those HIV-infected with a CD4 cell count at or below 350, as well as between 350 and 500, but did not have a recommendation for those with a CD4 count above 500.

“This revised recommendation is based on a growing body of evidence demonstrating the harmful effects of ongoing HIV replication and on the results of the [HIV Prevention Trials Network (HPTN)] 052 study,” said Charles B. Hicks, MD, from Duke University Medical Center in an article for Journal Watch AIDS Clinical Care. HPTN 052 demonstrated that ART reduces the likelihood of HIV transmission to an uninfected sexual partner by 96 percent. In the guidelines, the Prevention of Secondary HIV Transmission section is updated to reflect the HPTN 052 study and the role of ART in reducing transmission.

“Although not new, the more enthusiastic endorsement of ART for all reflects a recognition of the range of benefits of treatment coupled with longer-term safety and tolerability data on contemporary ART regimens,” Hicks said.

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