Issue 170 - October 2007
In this issue
The question of when to start treatment is one wrapped in many clinical and personal issues. Some find the thought of starting treatment difficult and hope to delay the possible risks of taking anti-HIV drugs, others want the benefits as soon as possible.
Just last year a friend explained how he regretted begging his doctor to start him on antiretroviral therapy the same week he was diagnosed. He wanted treatment despite having a high CD4 count, because he felt powerless and wanted to take action. The regret he felt came later as he learned more about resistance and long-term side effects. Had he put his body at unnecessary risk?
The recent 4th International AIDS Society Conference (IAS) in Sydney gave a bumper crop of news, so much so that we’ve devoted this entire issue to it, but one theme really stood out from the crowd. With several presentations on the potential benefits of early treatment, this conference could turn one man’s regret into hope.
Whether those new to treatment will benefit from an earlier starting block is the subject of much debate but the word from Sydney was that it’s time for a rethink.
page 3 Tailor-made medicines are the subject of this month’s Upfront. With genetic screening for abacavir’s hypersensitivity reaction pinpointing those at risk, will the side-effects be eliminated for good?
page 4 In or main feature How soon is too soon? we’ve gathered a wide range of evidence pointing towards better outcomes for those who start treatment early. Should treatment begin above the recommended 200 CD4 threshold and if so, when do we start? We ask UK experts what the implications could be for our clinics and find out if it’s time for a change in guidelines.
page 12 News In brief gives some highlights from IAS providing an update on pipeline drugs, as well as those more established, and finds out if efavirenz has met its match.
page 14 Prevention gets a mention too and our final piece gives an update on new technologies and how they can best be used. While condoms are effective, Enhancing prevention ensures we do our best in the fight against HIV.