HAART effective for AIDS management

Doctors from Britain have published evidence backing calls for treating HIV-infected patients before their immune system crashes below a commonly recognised threshold of damage inflicted by the AIDS virus.

Highly active antiretroviral therapy (HAART) began to overturn the automatic death sentence associated with AIDS after this powerful cocktail of drugs was introduced in 1996.

But a big question is when someone infected with the human immunodeficiency virus (HIV) should start to take the drugs.

Physicians have to balance the benefits of restoring immune defences against the risk of the treatment's side effects, which can be toxic.

There is no universal guideline for when HAART should be administered, but a common recommendation is to start the drugs when there are fewer than 200-250 CD4 cells - key immune cells that are attacked by the virus -- per microlitre of blood.

Some researchers say this threshold is too low and lives can be saved if drugs are started sooner, although hard evidence to back this is sketchy.

In a paper published in The Lancet on Thursday, a team led by Jonathan Sterne of Britain's University of Bristol compared studies that followed more than 45,000 HIV-infected people in Europe and North America before and after the HAART era.

Those who began HAART when their CD4 count was below 350 cells per microlitre were 28 per cent likelier to develop AIDS or die prematurely than those who grasped the lifeline when their CD4 tally was 351-450 cells per microlitre.