A publication of the International AIDS Society–USA Perspectives When to Start Antiretroviral Therapy: A Swinging Pendulum? 82

When to start antiretroviral therapy: a swinging pendulum?

Although early initiation of antiretroviral treatment has long been associated with some benefit over later initiation, the magnitude of the benefit is becoming better defined with longer follow-up of large numbers of patients in cohort studies. These benefits have become more evident in part because of improvements in efficacy, tolerability, and convenience of antiretroviral treatment regimens...

Cardiovascular risk and risk management in HIV-infected patients.

Patients with HIV infection are at risk of cardiovascular disease from the same factors posing risk in the general population--eg, smoking, dyslipidemia, hypertension, obesity, and diabetes. HIV infection itself and antiretroviral therapy pose additional risk, but available data indicate that the relative rate of myocardial infarction is low and declining in the HIV-infected population. Cardiov...

Immune dysfunction, inflammation, and accelerated aging in patients on antiretroviral therapy.

Patients receiving long-term antiretroviral therapy are at increased risk of age-associated non-AIDS-related morbidity and mortality compared with HIV-seronegative persons. Despite suppressive antiretroviral treatment, inflammation remains elevated and CD4+ count often remains low, with both measures predicting age-associated events. Several factors likely contribute to persistent inflammation ...

Initial Antiretroviral Therapy: When and With What to Begin.

At the International AIDS Society-USA course in Denver in May 2002, Donna E. Sweet, MD, discussed issues related to the ongoing question of when to initiate antiretroviral therapy in HIV-infected individuals and factors in selecting an initial drug regimen. Current treatment guidelines offer some consensus on the question of timing. Selection of the initial therapy focuses on the choice between...

Complications of HIV infection and antiretroviral therapy.