A Comparative Systematic Review of the Optimal CD4 Cell Count Threshold for HIV Treatment Initiation
HIV infection is no longer characterized by high morbidity, rapid progression to AIDS, and death as when the infection was first identified. While anti-retroviral drugs have improved the outcome of AIDS patients, clinical research on the appropriate time to initiate therapy continues to evolve. Opti...
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | Interdisciplinary Perspectives on Infectious Diseases |
| Online Access: | http://dx.doi.org/10.1155/2014/625670 |
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| author | Babatunde Olubajo Kathryn Mitchell-Fearon Oluseye Ogunmoroti |
| author_facet | Babatunde Olubajo Kathryn Mitchell-Fearon Oluseye Ogunmoroti |
| author_sort | Babatunde Olubajo |
| collection | DOAJ |
| description | HIV infection is no longer characterized by high morbidity, rapid progression to AIDS, and death as when the infection was first identified. While anti-retroviral drugs have improved the outcome of AIDS patients, clinical research on the appropriate time to initiate therapy continues to evolve. Optimal therapy initiation would maximize the benefits of these drugs, while minimizing side effects and drug resistance. Recent 2013 WHO guidelines changed HIV therapy initiation from 350 cells/μL to 500 cells/μL. This systematic review provides an evidence-based comparison of starting treatment at >500 cells/μL with starting treatment at the range between 350 cells/μL and 500 cells/μL. An 11% increase in risk was detected from initiation therapy at the 350–500 cells/μL range (0.37 [0.26, 0.53]), when compared with starting treatment before 500 cells/μL (0.33 [0.22, 0.48]). Most individual study comparisons showed a benefit for starting treatment at 500 cells/μL in comparison with starting at the 350–500 cells/μL range with risks ranging from 19% to 300%, though a number of comparisons were not statistically significant. Overall, the study provides evidence based support for initiating anti retroviral therapy at cell counts >500 cells/μL wherever possible to prevent AIDS mortality and morbidity. |
| format | Article |
| id | doaj-art-917f421b96c14c64bde6999c034e3151 |
| institution | Kabale University |
| issn | 1687-708X 1687-7098 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Interdisciplinary Perspectives on Infectious Diseases |
| spelling | doaj-art-917f421b96c14c64bde6999c034e31512025-02-03T07:26:02ZengWileyInterdisciplinary Perspectives on Infectious Diseases1687-708X1687-70982014-01-01201410.1155/2014/625670625670A Comparative Systematic Review of the Optimal CD4 Cell Count Threshold for HIV Treatment InitiationBabatunde Olubajo0Kathryn Mitchell-Fearon1Oluseye Ogunmoroti2Eastern Health Research and Analysis, Inc., 1 Press Place, Athens, GA 30601, USADepartment of Community Health and Psychiatry, The University of the West Indies, Mona, Kingston 7, JamaicaAtlanta English Institute, 4000 Dekalb Technology Parkway, Atlanta, GA 30340, USAHIV infection is no longer characterized by high morbidity, rapid progression to AIDS, and death as when the infection was first identified. While anti-retroviral drugs have improved the outcome of AIDS patients, clinical research on the appropriate time to initiate therapy continues to evolve. Optimal therapy initiation would maximize the benefits of these drugs, while minimizing side effects and drug resistance. Recent 2013 WHO guidelines changed HIV therapy initiation from 350 cells/μL to 500 cells/μL. This systematic review provides an evidence-based comparison of starting treatment at >500 cells/μL with starting treatment at the range between 350 cells/μL and 500 cells/μL. An 11% increase in risk was detected from initiation therapy at the 350–500 cells/μL range (0.37 [0.26, 0.53]), when compared with starting treatment before 500 cells/μL (0.33 [0.22, 0.48]). Most individual study comparisons showed a benefit for starting treatment at 500 cells/μL in comparison with starting at the 350–500 cells/μL range with risks ranging from 19% to 300%, though a number of comparisons were not statistically significant. Overall, the study provides evidence based support for initiating anti retroviral therapy at cell counts >500 cells/μL wherever possible to prevent AIDS mortality and morbidity.http://dx.doi.org/10.1155/2014/625670 |
| spellingShingle | Babatunde Olubajo Kathryn Mitchell-Fearon Oluseye Ogunmoroti A Comparative Systematic Review of the Optimal CD4 Cell Count Threshold for HIV Treatment Initiation Interdisciplinary Perspectives on Infectious Diseases |
| title | A Comparative Systematic Review of the Optimal CD4 Cell Count Threshold for HIV Treatment Initiation |
| title_full | A Comparative Systematic Review of the Optimal CD4 Cell Count Threshold for HIV Treatment Initiation |
| title_fullStr | A Comparative Systematic Review of the Optimal CD4 Cell Count Threshold for HIV Treatment Initiation |
| title_full_unstemmed | A Comparative Systematic Review of the Optimal CD4 Cell Count Threshold for HIV Treatment Initiation |
| title_short | A Comparative Systematic Review of the Optimal CD4 Cell Count Threshold for HIV Treatment Initiation |
| title_sort | comparative systematic review of the optimal cd4 cell count threshold for hiv treatment initiation |
| url | http://dx.doi.org/10.1155/2014/625670 |
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