HIV Spotlight on Center on Caring for the Newly Diagnosed Patient


Which HIV Treatment Regimen to Start With

September 24, 2015


Everyone Should Start

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.

Reader Comments:

Comment by: Jeffrey Berman (Laurel, MD) Sat., May. 14, 2016 at 10:03 pm UTC
I was diagnosed when I was 18 in 1987. I was told take AZT 6 pills a day or be dead in 6 months. I took it for a month and got side effects. I stopped the drug and for 22 years, I did not take anything. After 22 years, I started Atripla because my Viral Load was at 100,00 and I wanted to become undetectable. I have been on Atripla for 7 years and it messed up my Cholestrol and Trig. I recently had a minor heart attack and I have to stop taking Atripla. I was going to switch to Genvoya but the med that I take for my heart is not a good match. I allways said HIV will not kill me...The side effects will
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Comment by: curtis Edwards (Brooklyn, NY) Fri., Feb. 26, 2016 at 6:54 pm UTC
Personally wish that one day all of This be over and we can look back and say remember when there was HIV and AIDS what a memory will be behind us all until that time comes we have to be there For Family friends and people we don't even know
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Comment by: Mandla Pantsi (South Africa,Eastern Cape,P.E) Thu., Oct. 29, 2015 at 2:34 pm UTC
What is the correlation or relationship between genetic makeup of a person on HAART and the body's resistance to fighting the virus.
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Comment by: John Mfutakamba (SHINYANGA -TANZANIA) Wed., Oct. 28, 2015 at 4:00 am UTC
I am not sure if dolutegravir is free of serious side effects.I have to be enlightened on this aspect.It introduction in 2013 is not long enough period to come up with such a conclusion.
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Comment by: nicola boyle (Galway, ireland ) Mon., Oct. 12, 2015 at 4:19 am UTC
the Tivicay advert is so annoying, it makes it difficult to read the screen seeing this moving advert beside the text box is a total distraction

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Comment by: bruno rodrigues (providence ri) Wed., Sep. 30, 2015 at 8:02 am UTC
I would like to thank everyone involved in getting and keeping this website available for hiv positive patients and there friends and families. special thanks to dr lynn taylor for all the people she has helped including myself
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Comment by: Arnold (Houston, TX) Fri., Sep. 25, 2015 at 9:30 am UTC
Recently, my doctor asked me if I wanted to switch from my Atripla to Triumeq. One of his reasons was the depression you mentioned. I have been on Atripla
For 7 yrs with no issues and frankly, I love it.

I researched Triumeq only to find that major depression and suicidality were recently added to it labeling as well. I think your article should mention that new changes are added to me medications all the time and that we do not necessarily know everything about them just yet.

It seems like everyone wants to bash Atripla which has helped save my life and given me my future back to me. I don't think it is necessary to knock down one product that is the Gold standard, as you said, to promote another.
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Replies to this comment:
Comment by: Anonymous Sat., Oct. 3, 2015 at 11:05 am UTC
The last I heard was that Triumeq was implicated in a greater likelihood of cardiovascular issues. It's a marvelous drug, but it's not aspirin.

I once complained to the best HIV doctor I've had about Attipla's side effects. His immediate response was "they ALL have side effects". While I think Atripla is considered well past its prime-and rightly so-I can't help but wonder about what the next wave of complications is going to be? I find it conspicuous that we didn't acknowledge the well suspected side effects of Efavirenz until it approached the patent cliff, and feel we are used as cattle to be harvested at the inclination of large corporations.

True HIV advocacy-the sort this website is petrified of promoting-is to admit that these drugs aren't working. The side effects of any drug on drug on drug combination are not conducive to a well lived life, and we will never advocate our way out of stigma which looks more medieval by the day. The only true advocacy is to demand a cure.

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