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Community views balancing the public health benefits of earlier antiretroviral treatment with the implications for individual patients – perspectives from the community

Community views balancing the public health benefits of earlier antiretroviral treatment with... REVIEW URRENT Community views: balancing the public health PINION benefits of earlier antiretroviral treatment with the implications for individual patients – perspectives from the community a b Simon Collins and Nathan Geffen Purpose of review When should people with HIV start treatment? This question is widely debated. The recent momentum to initiate treatment at a CD4 cell count above 350 cells/mm is driven by the potential population benefits of antiretroviral treatment reducing infectiousness together with operational concerns. These are important. However, we focus on the clinical benefits and risks for the person taking treatment, and how this may vary depending on the background health setting. Recent findings We refer to the recent guideline changes and the limited evidence on which they are based. Many studies that have informed guideline changes reference plausible benefits, but have limited follow-up and are not designed to assess the potential risks. We note historical examples to show that expert opinion in the absence of data warrants caution. Summary Results from well powered studies designed to look at the question of when to start treatment are essential for quantifying the benefits and risks of earlier treatment. Meanwhile, the decision of when to start must be http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Current Opinion in HIV and Aids Wolters Kluwer Health

Community views balancing the public health benefits of earlier antiretroviral treatment with the implications for individual patients – perspectives from the community

Geffen, Nathan
Current Opinion in HIV and Aids , Volume 9 (1) – Jan 1, 2014
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References (58)

Copyright
© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
ISSN
1746-630X
eISSN
1746-6318
DOI
10.1097/COH.0000000000000024
pmid
24247668
Publisher site
See Article on Publisher Site

Abstract

REVIEW URRENT Community views: balancing the public health PINION benefits of earlier antiretroviral treatment with the implications for individual patients – perspectives from the community a b Simon Collins and Nathan Geffen Purpose of review When should people with HIV start treatment? This question is widely debated. The recent momentum to initiate treatment at a CD4 cell count above 350 cells/mm is driven by the potential population benefits of antiretroviral treatment reducing infectiousness together with operational concerns. These are important. However, we focus on the clinical benefits and risks for the person taking treatment, and how this may vary depending on the background health setting. Recent findings We refer to the recent guideline changes and the limited evidence on which they are based. Many studies that have informed guideline changes reference plausible benefits, but have limited follow-up and are not designed to assess the potential risks. We note historical examples to show that expert opinion in the absence of data warrants caution. Summary Results from well powered studies designed to look at the question of when to start treatment are essential for quantifying the benefits and risks of earlier treatment. Meanwhile, the decision of when to start must be

Journal

Current Opinion in HIV and Aids – Wolters Kluwer Health

Published: Jan 1, 2014

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