Treatment of Mildly Symptomatic Human Immunodeficiency Virus (HIV) Infection

  1. John D. Hamilton, MD;
  2. Michael S. Simberkoff, MD; and
  3. Pamela Hartigan, PhD
  1. Veterans Affairs Cooperative Studies Program
    Durham Veterans Affairs Medical Center
    Durham, NC 27705

    Excerpt

    To the Editors: The recent article by Fischl and colleagues (1) concludes with the sentence, "Based on the findings in this study, patients with mildly symptomatic HIV infection who have less than 500 CD4 T lymphocytes/mm3 now have an opportunity to significantly delay the rate of disease progression and, thus, to prolong their disease-free survival." We do not believe that the data presented support that conclusion.

    Several studies have shown that the risk for developing the acquired immunodeficiency syndrome (AIDS)-defining opportunistic infections increases dramatically after the CD4 concentration falls below 200/mm3 (2-4). Fischl and colleagues (1) provide the baseline CD4

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