San Francisco public health doctors are urging patients to begin taking HIV medications soon after their diagnosis rather than waiting until their immune systems become compromised, The New York Times reports. The city’s Department of Public Health will announce the new testing guidelines this week.
According to the article, the policy shift was prompted by evidence that patients who start antiretroviral treatment earlier are more likely to live longer and less likely to develop illnesses—such as heart disease, kidney failure and cancer—that are common among long-term survivors. A recent study in The New England Journal of Medicinefound that patients who put off therapy until their immune system started failing had a nearly twofold greater risk of dying—from any cause—than those who began treatment when their CD4 counts were above 500.
Under San Francisco’s new policy, doctors will offer patients combination therapy and advise them to pursue early treatment, but the patients will ultimately decide whether to begin therapy right after their diagnosis.