Question
Do you believe Dr Fauci's claim for a cure from early treatment?
7 July 2008. Related: All topics, Cure, Living with HIV long-term, Starting treatment.
Hi
Should i start treatment early, or wait till my CD4 count drops to 350?
According to Anthony Fauci, director of NIH’s National Institute of Allergy and Infectious Diseases, in this article online, early treatment with combination therapy can stop HIV within 7.7years. Is it true?
http://www.thebody.com/content/news/art41026.html
Answer
Although a cure will eventually be found, I don’t think this is it.
Dr Fauci is just making optimistic but informed guess based on our limited knowledge of one type of immune cell that is infected with HIV, but which is also sleeping.
People have already been on treatment for over seven years, but when they stop treatment the virus still comes back.
When combination therapy was first introduced, researchers thought the virus might be eradicated (ie cured) after 3 years of treatment. The next year other models suggested 20 years, then 50 years, then 70 years and more recently shorted periods again.
The last paragraph of the article is important. If only one sleeping infected cell remains, this would be enough to start a new infection.
HIV is also likely to be in other cells or compartments that we don’t know much about. This occurs within the first few weeks of infection – which is before most people even know they have HIV, and certainly before it is possible to use treatment.
Without knowing your details, then if you have no other symptoms, following current treatment guidelines and waiting until your CD4 count reaches 350 is good advice.
If you want to start treatment earlier, then consider joining the large international START study will randomise people to either start treatment while their CD4 count is still above 500, or wait until it reaches 350.
This is one of the most exciting and important studies currently being run. For more information, including US trial sites, see the START study website.
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