HAART Can Be Safely Delayed as Long as Viral Loads Are Low

Researchers at the Northwestern University School of Medicine report in the December 6 issue of AIDS that anti-HIV drug therapy can be safely delayed in people with CD4-cell counts below 350, even as low as 200, if blood-based viral loads remain low. Using data from the Multicenter AIDS Cohort Study, scientists found that among HIV-positive people in 1985 with CD4-cell counts between 201 and 350 and viral loads between 10,001 and 20,000 copies per microliter of blood, only 4% progressed to AIDS after two years and 11% after three years. About half of the study subjects in the 201'350 CD4-cell group with viral loads between 50,000 and 60,000 developed low CD4 counts within three years. Among patients with CD4-cell counts above 350 and viral loads below 60,000, none progressed to AIDS within a year. The researchers conclude that antiretroviral therapy can be safely deferred for patients with CD4-cell counts above 200 and viral loads less than 20,000 as well as for those with CD4-cell counts above 350 and viral loads under 60,000.