May 31, 2012

May 31, 2012
When to Start HIV Treatment

Welcome to another day in my life. Today is Thursday and it is also the last day of May. I hope you have had a safe and great week so far. I can not believe how quickly this year is going by. Dab the AIDS Bear and I have been on the run again this week. So stay tuned for slide shows coming up in the next couple of days.

Not starting HIV treatment until CD4 cell count has fallen below the 350 threshold is associated with an important early warning sign of cardiovascular disease, new research shows.

US doctors found that starting HIV treatment below 350 cells/mm3 was associated with poorer endothelial function – blood flow through the arteries.

Previous research has shown that the risk of cardiovascular disease is increased for people with HIV. However, there’s uncertainty about the exact causes.

Traditional risk factors are important. But the side effects of some anti-HIV drugs may increase the long term risk of diseases such as heart attack and stroke.

However, there is now a lot of evidence that the damage caused by HIV is also an important factor.

In this study, doctors compared endothelial function in people who started HIV therapy when their CD4 cell count was below 350 with those who started treatment at a higher CD4 cell count.

They found that endothelial function was significantly poorer in the people who started HIV therapy at lower CD4 cell counts.

They emphasis that this had a similar impact to having diabetes, smoking, or existing cardiovascular disease.

Current guidelines about the use of HIV treatment recommend that, as is currently recommended for most people with HIV, people with a risk of cardiovascular disease should start treatment when their CD4 cell count is around 350. The authors concluded there was not enough evidence to say that having risk factors for cardiovascular disease should mean a different approach to treatment, such as starting earlier.

The guidelines recommend that people with HIV should have their risk of cardiovascular disease assessed every year as part of their routine care. This allows problems to be spotted early so appropriate treatment can be offered.

If you smoke, stopping smoking is a really important step you can take to look after your health. Eating a healthy diet, taking regular exercise and not drinking too much alcohol are all ways of reducing your risk of cardiovascular disease.

So now you know the rest of the story. Hope you have a great Thursday.

Until we meet again; here's wishing you health, hope, happiness and just enough.

big bear hug

Daddy Dab