A clinical trial supported by the National Institutes of Health has found that starting antiretroviral therapy earlier than currently recommended may greatly improve outcomes for HIV-infected patients.
   The trial, which took place in Haiti, included 816 adults with early HIV disease and CD4+ cell counts between 200 and 350 cells/mm³. One-half of the patients started antiretroviral therapy right away; the other half started treatment when their CD4+ cell counts fell below 200 cells/mm³ or they were diagnosed with AIDS.
   An interim evaluation revealed that, among the early-treatment group, 6 patients had died and 18 people had developed tuberculosis. Among the standard-of-care group, 23 people had died and 36 had developed tuberculosis. These results were so striking that researchers stopped the trial early and offered antiretroviral therapy to all the enrolled patients.
   The researchers said their finding could change the standard of care for treating HIV infection, especially in areas of the world where access to antiretroviral drugs is limited. They also stressed the need to detect HIV infection earlier, before CD4+ cell counts have declined.

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