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September 8, 2004

Staging for Antiretroviral Therapy Among HIV-Infected Drug Users

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2004;292(10):1175-1177. doi:10.1001/jama.292.10.1175-b

To the Editor: Highly active antiretroviral therapy (HAART) has been shown to substantially decrease mortality among patients infected with human immunodeficiency virus (HIV).1 However, treatment guidelines have recently supported initiating HAART later in the course of HIV infection. This requires that monitoring of CD4 cell counts be conducted at the time of HIV diagnosis and every 3 months thereafter to ensure treatment is initiated before patients become vulnerable to opportunistic infections.1,2 This may require interventions for populations who may be at risk of poor access to health care.3 We evaluated rates of CD4 cell count monitoring among users of injection drugs having access to free HIV/AIDS care and antiretroviral therapy.4