Improved Outcomes with Earlier Initiation of Highly Active Antiretroviral Therapy Among Human Immunodeficiency Virus–Infected Patients Who Achieve Durable Virologic Suppression: Longer Follow‐Up of an Observational Cohort Study

Abstract
On the basis of studies with relatively short follow-up, treatment guidelines currently recommend that highly active antiretroviral therapy (HAART) be initiated in asymptomatic human immunodeficiency virus–infected patients when the CD4+ lymphocyte count is ⩽200 cells/mm3. We assessed the development of a new opportunistic infection or death among 1173 patients initiating HAART. Durable virologic suppression was defined as having more undetectable (+ lymphocyte counts of 350 cells/mm3 (P=.01). Among those with durable virologic suppression, there was no difference in disease progression between those with baseline CD4+ lymphocyte counts of 201–350 cells/mm3 and those with durable virologic suppression with baseline CD4+ lymphocyte counts of >350 cells/mm3 (P=.40). Initiating HAART with a CD4+ lymphoctye count of 200 cells/mm3

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