VIENNA – A major expert panel recommended ahead of the start of the world Aids conference in Vienna yesterday that patients with HIV start antiretroviral drugs at an earlier stage of infection.

Earlier initiation of  the drugs that repress  the human  immunodeficiency virus (HIV) can  reduce long-term  mortality and sickness, the  group said.

It set out its recommendations in a paper  published by  the Journal of the American  Medical Association, and   presented in Vienna  before the six-day 18th   International Aids Conference got under way.

The group suggested  that infected individuals  be  treated when their  count of CD4 cells  reached 500 or  below.

Therapy “should be  considered” for non- symptomatic  patients  with more than 500 cells  per microlitre, it said,   adding: “There is no  CD4 cell count threshold  at which  initiating therapy is contra-indicated,”  or inadvisable.

 Therapy is also recommended for patients  who are  pregnant, older  than 60, are co-infected  by hepatitis B or  C and  at high risk of cardiovascular disease.

The CD4 count is the  one major barometer of  infection  by HIV.

A healthy, uninfected  person has a CD4 count  of  between 1000 and  1500 cells. Under UN  guidelines,  treatment is  advised when infection  is at 350 CD4 cells  .

Changes in guidelines  have consequences that  reach  into many  spheres.

Treating people  sooner means boosting  the drugs bill at  a time  of widening austerity.

It also requires having  the infrastructure in  place –  doctors, nurses  and labs – to ensure the  therapy is  being properly followed and the  patient is responding to  treatment.