Issue No. 6

Study Suggests That Earlier HAART Leads to Better Health, Fewer Toxicities

A retrospective epidemiological study based on the medical records of over 2000 HIV patients suggests that beginning HAART earlier may result in better health outcomes and fewer drug-related toxicities.

Researchers at the Centers for Disease Control and Prevention and the University of Colorado Health Sciences Center reported their results at the 13^th Conference on Retroviruses and Opportunistic Infections (CROI), held earlier this week in Denver, Colorado. The study compared patients who started HAART with a CD4 count of 200 cells/mL or less with patients who began treatment with a CD4 count of 350 cells/mL or more. Those who began treatment with a higher CD4 count were less likely to develop kidney problems, peripheral neuropathy and lipoatrophy.

These results were surprising because conventional wisdom held that delaying treatment would lessen toxicity by reducing exposure to drugs and their side effects. This study suggests the opposite: that by beginning treatment earlier, side effects are minimized.

Study Evaluates Immune Reconstitution Inflammatory Syndrome (IRIS) in HIV-1 Infected Patients

The National Institute for Allergy and Infectious Diseases (NIAID) is sponsoring a cohort observational study evaluating the incidence and immunopathogenesis of immune reconstitution syndrome (IRIS) following investigation of HAART in HIV-1 infected patients with CD4 counts below 100 cells/mL.

Immune Reconstitution Syndrome (IRS), also known as immune reconstitution inflammatory syndrome (IRIS), is an inflammatory reaction that can occur when an immunocompromised person's immune system improves, such as when a person with HIV disease begins anti-HIV treatment and experiences a rise in CD4 cell count. Fever, along with swelling, redness, or discharge at the site of an injury or infection, may signal that an infection previously unnoticed by a weak immune system is now a target of a stronger immune system. Although IRS indicates that a person's immune system has grown healthier, it can be a serious, sometimes fatal condition and must be treated aggressively. To read more about this study, go to: http://clinicaltrials.gov/ct/show/NCT00286767?order=1.