Everyone Should Start
Last year, the results of the aptly named START study upended previously held ideas about which patients should begin treatment. Previously, guidelines suggested that HIV-positive patients with robust, functioning CD4+ cells (immune lymphocytes) should wait. Only once patients' CD4+ count dropped below 350 cells/mm3 would they be recommended for treatment. The START study asked, "should we wait?" and the answer was definitive. Patients who started on highly active antiretroviral therapy (HAART) right away were healthier than patients who were told to wait until their CD4+ was less than 350 cells/mm3. Because of this important trial, HAART should be offered to any newly diagnosed patient.