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What is the optimal CD4 count to start antiretroviral therapy?

KEY POINT

Two recently published observational studies showed that starting antiretroviral therapy in patients with CD4 counts greater than 350 cells/mm3 was associated with a significantly lower risk of death and lower rates of AIDS and death.

SOURCES

Kitahata MM et al. Effect of early versus deferred antiretroviral therapy for HIV on survival. N Engl J Med. 2009;360:1815–26. 

Sax PE et al. When to start antiretroviral therapy-ready when you are. N Engl J Med. 2009;360:1897–9. 

When to Start Consortium. Timing of initiation of antiretroviral therapy in AIDS-free HIV-1-infected patients: a collaborative analysis of 18 HIV cohort studies. Lancet. 2009;373:1352–63. 

Wood R et al. Should the CD4 threshold for starting ART be raised? Lancet. 2009;373:1314–6.