Overcoming Impediments to Global Implementation of Early Antiretroviral Therapy  

Oleh:

Karim, Salim S. Abdool

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The New England Journal of Medicine (keterangan: ada di Proquest) vol. 373 no. 09 (Aug. 2015), page 875-876.

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Perpustakaan FK Nomor Panggil: N08.K Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

Antiretroviral therapy (ART) has transformed the global response to the human immunodeficiency virus (HIV) epidemic by reducing the incidence of acquired immunodeficiency syndrome (AIDS)–related death and disease. However, when to start ART in asymptomatic persons has long been debated. Initial calls to “hit HIV early and hard” two decades ago1 were countered by the pragmatic prioritization of patients at highest risk for AIDS — namely, those with low CD4+ cell counts (=200 cells per cubic millimeter). This threshold for ART initiation has been progressively increasing, first to 350 cells per cubic millimeter and most recently to 500 cells per cubic millimeter, as new data from randomized, controlled trials became available. Two studies now reported in the Journal — the TEMPRANO ANRS 12136 study2 and the Strategic Timing of Antiretroviral Treatment (START) study3 — provide important additional evidence to support early ART initiation by demonstrating its clinical benefits in asymptomatic patients at an early stage of their disease, when CD4+ cell counts are above 500 cells per cubic millimeter.

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