The International AIDS Society-USA guidelines support initiating antiretroviral therapy before CD4 cell count declines to less than 350/ μL.
Rapid decline in CD4 cell count, high plasma HIV-1 RNA levels, risk factors for cardiovascular disease and the presence of other diseases such as hepatitis B or C should be considered when deciding when to initiate therapy.
The initial drug regimen should be tailored to the individual, particular in the presence of other illnesses, authors write.
Levels of HIV-1 RNA in blood plasma should also be monitored frequently, the guidelines say.
Journal of the American Medical Association (2008) 300:555-570