Hey there Guys,
Some great news reported recently in the Journal of the American Medical Association (JAMA) about changing treatment guidelines for people living with HIV, suggesting early treatment regardless of CD4 count.
Current guidelines suggest holding back on starting HIV treatments until there is a drop in CD4 count to below 500, or if there was a AIDS defining illness or opportunistic infection.
Recent reviews of evidence around HIV treatments show that there is increased benefits for many people by starting HIV treatment early regardless of CD4 count. Early treatment can reduce risk of opportunistic infections and reduce the risk of progression to AIDS. Early treatment also reduces the associated non immune related side effect of HIV including heart disease, nerve damage, cancers and other medical conditions. These diseases are believed to be caused by the chronic inflammation in the body from HIV infection.
In the paper Antiretroviral Treatment of Adult HIV Infection the authors recommend offering HIV treatment people at all stages of HIV infection including seroconversion, diagnosis of opportunistic infections and pregnancy, no matter the CD4 count.
HIV treatments are complex and lifelong so willingness to start treatment and understanding that treatments are a life long journey is vital to ensure most benefit and prevention of resistant strains of HIV developing.
This news combined with developments in HIV PrEP medications, potential vaccines and ongoing improvement of HIV treatments are all strong steps forward for HIV prevention and care of all people currently living with HIV and reducing the rate of HIV infection.
If you are currently HIV positive and not on a treatment, now may be a great time to start the conversation with your doctors no matter your current CD4 count.
Yours in great health.
Dr George
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