Optimal time for initiation of antiretroviral therapy in asymptomatic, HIV-infected, treatment-naive adults

Cochrane Database of Systematic Reviews, 2011

Optimal time for initiation of antiretroviral therapy in asymptomatic, HIV-infected, treatment-naive adults - The Cochrane Library - Siegfried - Wiley Online Library from LOGIN Enter e-mail address Enter password REMEMBER ME > > > > DATABASE TOOLS DATABASE MENU FIND ARTICLES OTHER RESOURCES Intervention Review You have full text access to this content Optimal time for initiation of antiretroviral therapy in asymptomatic, HIV-infected, treatment-naive adults Nandi Siegfried 1,* , Olalekan A Uthman 2 , George W Rutherford 3 Editorial Group: Published Online: 17 MAR 2010 Assessed as up-to-date: 12 NOV 2009 DOI: 10.1002/14651858.CD008272.pub2 Copyright © 2011 The Cochrane Collaboration.
Optimal time for initiation of antiretroviral therapy in asymptomatic, HIV-infected, treatment-naive adults.
Publication History Publication Status: Edited (no change to conclusions) Published Online: 17 MAR 2010 SEARCH ARTICLE TOOLS Abstract Abstract Background According to consensus, initiation of therapy is best based on CD4 cell count, a marker of immune status, rather than on viral load, a marker of virologic replication.
However, the point during the course of HIV infection at which antiretroviral therapy (ART) is best initiated in asymptomatic patients remains unclear.
Guidelines issued by various agencies provide different initiation recommendations according to resource availability.
This can be confusing for clinicians and policy-makers when determining the best time to initiate therapy.
Optimizing the initiation of ART is clearly complex and must, therefore, be balanced between individual and broader public health needs.
Objectives To assess the evidence for the optimal time to initiate ART in treatment-naive, asymptomatic, HIV-infected adults Search methods We formulated a comprehensive and exhaustive search strategy in an attempt to identify all relevant studies regardless of language or publication status (published, unpublished, in press, and in progress).
In August 2009, we searched the following electronic journal and trial databases: MEDLINE, EMBASE, and CENTRAL.
We also searched the electronic conference database of NLM Gateway, individual conference proceedings and prospective trials registers.
We contacted researchers and relevant organizations and checked reference lists of all included studies.