HIV JournalView

Table of Contents

• When to Start Antiretroviral Therapy?
• When to Stop Antiretroviral Therapy?
• Effectiveness of Antiretroviral Therapy in Older Patients
• Effectiveness of Hepatitis A Vaccination
• Footnotes

When to Start Antiretroviral Therapy?

Faye A, Le Chenadec J, Dollfus C, et al. Early versus deferred antiretroviral multidrug therapy in infants infected with HIV type 1. Clin Infect Dis. December 1, 2004;39(11):1692-1698.

Holmberg SD, Palella FJ Jr, Lichtenstein KA, Havlir DV. The case for earlier treatment of HIV infection. Clin Infect Dis. December 1, 2004;39(11):1699-1704.

Cohen CJ, Boyle BA. Editorial commentary: antiretroviral therapy: the "when to start" debates. Clin Infect Dis. December 1, 2004;39(11):1705-1708.

Few topics in HIV medicine evoke as much heated debate as the subject of when to start antiretroviral therapy. The December 1, 2004 issue of Clinical Infectious Diseases provides a relevant research paper and excellent viewpoint articles.

In the first research article, Albert Faye and his team examined the effects of early versus delayed antiretroviral therapy in 83 HIV-infected infants in the French Perinatal cohort. Given the potential for life-long use of combination HIV treatment for HIV-infected infants and children, this group of patients amplifies the concerns about long-term drug toxicities and the interest in strategies that might decrease the total time of drug exposure. Additionally, about one fifth of infected children go on to develop a more severe form of HIV disease (including HIV encephalopathy) and an understanding of prognostic factors for children at risk are lacking.

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