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Invited Commentary
Sep 26, 2011

HAART for HIV-1 Infection: Zeroing In on When to StartComment on “Timing of HAART Initiation and Clinical Outcomes in Human Immunodeficiency Virus Type 1 Seroconverters”

Author Affiliations

Author Affiliations: Section of Retroviral Therapeutics, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts.

Arch Intern Med. 2011;171(17):1569-1570. doi:10.1001/archinternmed.2011.402

Great strides have been made in the treatment of HIV-1 infection since HAART was introduced almost 25 years ago. The result has been a dramatic reduction in cases of AIDS and AIDS-related mortality in industrialized countries; a similar impact is being made in resource-limited settings with the rollout of HAART during the last decade. Whereas the benefits of HAART are uncontested, the question of when to start HAART remains controversial. There is consensus that HAART should be offered to HIV-infected patients with CD4 cell counts lower than 350/μL, and for those with symptomatic HIV infection or AIDS-defining conditions regardless of CD4 cell count14; whether to offer HAART to asymptomatic patients with higher CD4 cell counts is unresolved.

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