The Early Bird

Two new studies add to the growing data suggesting that the "hit early, hit hard" HIV treatment approach may be best after all. These analyses have shown that the risk of early death is dramatically lower for people who begin treatment before current guidelines recommend. The first study -- an analysis of the medical records of more than 8,000 HIVers -- indicates that people who started anti-HIV meds when their CD4 count dropped below 350, which is the currently recommended treatment threshold, had a 69% higher risk of early death than those who began treatment with CD4 counts between 351 and 500. The second study, of 9,000 HIVers, indicates that starting even earlier may be the most beneficial. Participants who began treatment with CD4 counts below 500 had a 96% higher risk of early death than those who started therapy with a count above 500. "The evidence mounting from our data and other data suggests it makes sense to start therapy earlier," says study author Richard Moore of Johns Hopkins University.