Many with HIV start care too late

May 28, 2010

Despite growing evidence that the earlier people are diagnosed with HIV and get access to care, the better their clinical outcomes, many HIV-infected people in the United States and Canada are not receiving the care they need early enough. A study of nearly 45,000 patients in both countries highlighting this trend appears in the June 1, 2010, issue of Clinical Infectious Diseases, now available online.

Researchers analyzed patients' CD4 cell counts, a critical measure of immune system strength, when these patients first began clinical care for from 1997 to 2007. Although the median CD4 count at first presentation increased annually over this period, from 256 cells/mm3 to 317 cells/mm3, it remains below the level currently recommended for patients to start antiretroviral therapy, 350 cells/mm3. The median age at which patients first received HIV care increased over the study period from 40 to 43 years of age.

"The public health implications of our findings are clear: Delayed diagnosis reduces survival, and individuals enter into HIV care with lower CD4 counts than the guidelines for antiretroviral therapy initiation," said study author Richard Moore, MD, of Johns Hopkins University School of Medicine in Baltimore. "A delay in presentation for treatment not only increases the chance of clinical disease progression but also increases the risk of ongoing transmission."

In an accompanying editorial, Cynthia Gay, MD, of the University of North Carolina at Chapel Hill, agreed: "These findings reveal that despite such compelling data, there is much room for improving our ability to link more HIV-infected individuals with effective treatment prior to immunological deterioration."

Explore further: Latent HIV may lurk in 'quiet' immune cells, research suggests

More information: http://www.journals.uchicago.edu/doi/abs/10.1086/652650

add to favorites email to friend print save as pdf

Related Stories

Has HIV become more virulent?

Apr 07, 2009

Damage to patients' immune systems is happening sooner now than it did at the beginning of the HIV epidemic, suggesting the virus has become more virulent, according to a new study in the May 1, 2009 issue of Clinical In ...

HIV patients sicker when seeking care than in the past

Oct 25, 2007

It was hoped that as HIV treatment improved and as HIV-related public health initiatives encouraged people to be tested for the disease and seek care, that HIV-infected patients would seek care quickly. Unfortunately, a new ...

HIV measurement is questioned

Sep 27, 2006

Preliminary U.S. research indicates the HIV RNA level in untreated HIV-infected patients has little value in predicting the rate of CD4 cell count decrease.

Recommended for you

HIV testing yields diagnoses in Kenya but few seek care

Jan 29, 2015

Between December 2009 and February 2011, health workers with the AMPATH Consortium sought to test and counsel every adult resident in the Bunyala subcounty of Kenya for HIV. A study in the journal Lancet HIV reports that the campaign yielded more than 1,300 new positive diagnoses, but few of those new ...

The adaptability of pathogens

Jan 28, 2015

Drug-resistant HIV viruses can spread rapidly. This is the conclusion of a study conducted as part of the SWISS HIV Cohort Study, which is supported by the SNSF. Only the continuous introduction of new drugs can stop the ...

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.