In 2008, it was estimated that about 33.4 million people in the world were living with HIV/AIDS. In 2007, it was recorded that 159 American children were diagnosed with the disease.Ever since drugs were combined to form the antiviral treatment to slow the effects of HIV, the question of when to start has been raised. Recent discoveries have shown that the answer is as soon as possible.
Doctors in San Francisco have decided to urge patients to start antiviral treatments as soon as they are diagnosed with HIV. Previously, doctors would wait until the patient’s immune systems began to fail before beginning treatment.
For some people, by the time they start the medication, it is too late.
Evidence has been piling up that the sooner the drugs are started, the more likely patients are to avoid and delay kidney failure, heart disease, and cancer.
This research has concluded that people with HIV can live longer and be healthier and all they have to do is start earlier on the same treatment they would have taken anyway.
Antiviral treatment can have harsh side effects, such as birth defects and an increase in cardiovascular risks. However, these side effects are unavoidable, no matter when the treatment is started, and should not be used as a reason to avoid starting treatment.
Dr. C. Bradley Hare, a doctor who works in a HIV clinic in San Francisco, told The New York Times that “most of his patients did not have serious problems with drug side effects.”
The risk of side effects is worth it when the immune system of someone suffering from HIV can look like that of someone 30 years older. Also, antiviral medicine is safer now than it was when first introduced in 1996.
Not only will starting the medicine sooner allow for longer lives, it may prevent new infections.
“I do anticipate it will drive down the rates of new infections,” Dr. Mitchell H. Katz, San Francisco director of public health, said to The New York Times. “It’s a nice, secondary benefit of this new policy.”
By cutting down on the likelihood of transferring the disease, the numbers of people infected with HIV will hopefully decrease over time. If this isn’t an incentive to start the medicine sooner, then what is?
Opponents of starting the treatment at diagnosis say that the medications cost too much. Current HIV treatment uses $350 million of California’s AIDS Drug Assistance Plan.
The recent plan was started with no clear cost in mind. The chief of the California’s Office of AIDS, Dr. Michelle Roland, and other doctors across the country are working to figure out the costs of early treatments.
Even if the cost of early medication was more than the current cost, it would be worth it to allow those infected with HIV to spend more time with their loved ones.
Others say that the treatments are just too risky, because the long-term side effects of the antiviral treatments are not fully known.
But Kitahata and her fellow researchers discovered that patients who held off on therapy until the last second had nearly a twofold risk of dying from any cause, not just HIV.
Starting HIV treatment at diagnosis could not only save lives, but it could prevent others from ever having to start antiviral treatment in the first place. For a disease that has crippled millions of lives, this is the first step towards longer and healthier lives.