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In a research letter to the Journal of American Medical Association, researchers from Johns Hopkins University School of Medicine report a retrospective comparison of the outcomes of starting highly active antiretroviral therapy (HAART) at different CD4 cell count and viral loads.

The authors focused on reduction of HIV RNA to less than 400 copies in at least one instance within six months of beginning therapy (initial response) and response with no following increase in HIV RNA to over 1,000 copies (durable response). Nearly two-thirds of the patients achieved HIV RNA loads of less than 400 copies, while only 42 percent of the initial responders and 27 percent overall had durable responses.

The researchers recommend that the initial timing of HAART take into account both viral load and CD4 cell count, as the data seems to suggest that the therapy may have a better chance of success in suppressing viremia if given before the disease advances to moderate or severe infection.

Editor's Note: from JAMA