HIV Treatment Delays: CD4 Count Study Reveals Late Care
Author: Infectious Diseases Society of America
Published: 2010/05/29 - Updated: 2026/02/13
Publication Type: Research, Study, Analysis
Category Topic: HIV - Aids - Related Publications
Page Content: Synopsis - Introduction - Main - Insights, Updates
Synopsis: This research, published in the peer-reviewed journal Clinical Infectious Diseases, analyzes clinical data from nearly 45,000 HIV patients across the United States and Canada between 1997 and 2007. The study tracks CD4 cell counts - a critical indicator of immune system health - at the point when patients first entered clinical care, revealing that despite gradual improvements over the decade, median CD4 counts remained below the recommended threshold for starting antiretroviral therapy. Authored by researchers from Johns Hopkins University School of Medicine and supported by the Infectious Diseases Society of America, this information proves particularly valuable for people with HIV, healthcare providers, and immunocompromised individuals who need to understand the relationship between early diagnosis, timely treatment initiation, and improved health outcomes, while also highlighting public health concerns about ongoing viral transmission when care is delayed - Disabled World (DW).
Introduction
Many People with HIV Start Treatment Too Late
Study highlights need for earlier diagnosis and treatment - Despite growing evidence that the earlier people are diagnosed with HIV and get access to care, the better their clinical outcomes, many HIV-infected people in the United States and Canada are not receiving the care they need early enough.
A study of nearly 45,000 patients in both countries highlighting this trend appears in the June 1, 2010, issue of Clinical Infectious Diseases. now available online. Researchers analyzed patients' CD4 cell counts, a critical measure of immune system strength, when these patients first began clinical care for HIV from 1997 to 2007.
Main Content
Although the median CD4 count at first presentation increased annually over this period, from 256 cells/mm3 to 317 cells/mm3, it remains below the level currently recommended for patients to start anti-retroviral therapy, 350 cells/mm3. The median age at which patients first received HIV care increased over the study period from 40 to 43 years of age.
"The public health implications of our findings are clear: Delayed diagnosis reduces survival, and individuals enter into HIV care with lower CD4 counts than the guidelines for anti-retroviral therapy initiation," said study author Richard Moore, MD, of Johns Hopkins University School of Medicine.
"A delay in presentation for treatment not only increases the chance of clinical disease progression but also increases the risk of ongoing transmission."
In an accompanying editorial, Cynthia Gay, MD, of the University of North Carolina at Chapel Hill, agreed:
"These findings reveal that despite such compelling data, there is much room for improving our ability to link more HIV-infected individuals with effective treatment prior to immunological deterioration."
Founded in 1979, Clinical Infectious Diseases publishes clinical articles twice monthly in a variety of areas of infectious disease, and is one of the most highly regarded journals in this specialty. It is published under the auspices of the Infectious Diseases Society of America (IDSA).
Based in Arlington, Va., IDSA is a professional society representing more than 9,000 physicians and scientists who specialize in infectious diseases.
The HIV Medicine Association (HIVMA), nested within IDSA, is the professional home for more than 3,800 physicians, scientists, and other health care professionals dedicated to the field of HIV/AIDS.
Insights, Analysis, and Developments
Editorial Note: The findings presented in this study underscore a persistent gap between clinical best practices and real-world treatment patterns that has significant consequences for individual health and community transmission rates. While the data shows modest improvement in CD4 counts at initial presentation over the study period, the fact that patients continue to enter care below optimal treatment thresholds suggests that barriers to early HIV testing and prompt linkage to care remain stubbornly entrenched more than a decade into the antiretroviral therapy era. This research serves as a call to action for public health systems to strengthen screening programs and reduce the structural obstacles that prevent HIV-positive individuals from accessing lifesaving treatment before their immune systems become compromised - Disabled World (DW).Attribution/Source(s): This quality-reviewed publication was selected for publishing by the editors of Disabled World (DW) due to its relevance to the disability community. Originally authored by Infectious Diseases Society of America and published on 2010/05/29, this content may have been edited for style, clarity, or brevity.