Early initiation of treatment for HIV infection.

摘要

On Dec 1, 2009, the US Department of Health and Human Services (DHHS) issued updated guidelines for treatment of HIV infection, which include the statement that "the Panel recommends antiretroviral therapy in patients with CD4 counts between 350 and 500 cells/mm The data cited in support of this statement are from two large collaborative analyses of data from observational studies, from ART CC andNA ACCORD. A randomised trial still in progress (START) is randomising people with a CD4 cell count of greater than 500 per ui to either start antiretroviral therapy (ART) immediately or defer to a CD4 cell count of 350 per mu.L We are concerned that some may interpret the new recommendations as implying that the deferral group of this trial is no longer ethical. Such an interpretation would endangerthe future of the trial in the USA.