Initiation of Highly Active Antiretroviral Therapy at CD4+T Lymphocyte Counts of >350 cells/mm3: Disease Progression, Treatment Durability, and Drug Toxicity

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Abstract
We compared clinical disease progression in 159 human immunodeficiency virus (HIV)-infected persons for whom highly active antiretroviral therapy (HAART) was initiated when they had CD4+ T lymphocyte counts of 350–499 cells/mm3 with progression in 174 HIV-infected patients for whom it was not. Disease progression did not differ between the 2 groups (P =.21, log-rank test). Fifty-three percent of the 159 treated patients had HIV type 1 RNA levels of >400 copies/mL at the most recent evaluation, and 41% had experienced adverse drug reactions necessitating a change in regimen. These findings support the recommendation that HAART not be initiated for patients with CD4+ cell counts of >350 cells/mm3.