San Francisco Health Officials Advise Early Treatment for People with HIV

A meeting to discuss San Francisco's new HIV treatment policy drew a capacity crowd at San Francisco General Hospital (SFGH)'s Carr Auditorium on April 13. City health officials want all people diagnosed with HIV offered treatment immediately, rather than later.

"Based on accumulated data, we believe all HIV-infected persons should be treated with antiretroviral therapy unless there is a strong reason not to," said Dr. Mitch Katz, city Department of Public Health director.

"We now know that from the start HIV is causing damage to more than just the immune system," said Dr. Diane Havlir, chief of the University of California-San Francisco (UCSF)'s Division of AIDS at SFGH. "The virus is causing damage to multiple organs - including the heart, liver, kidneys, and probably the brain - even when a person has high CD4s and feels fine."

In a December report, 55 percent of experts convened by the US Department of Health and Human Services "strongly" recommended initiation of antiretroviral therapy when CD4 cell counts are 350 to 500 cells/cubic millimeter. Forty-five percent supported this specific guideline "moderately." In addition, 50 percent of panel members moderately recommended treatment initiation at CD4 counts above 500, with 50 percent viewing this as "optional."

SFGH began recommending earlier treatment after discussions among staff providers in January, said Medical Director Dr. Brad Hare. The new policy applies equally to other city facilities, said Katz.

"We've never debated about whether we think low-income people are entitled to the same advances as everyone else," Katz said. "There's one standard of care, whether you're on the hill at [UCSF] Parnassus, at Kaiser or here at SFGH."

"We encourage people not to use lack of funding to avoid doing what is right, but to stand with us and advocate for more," said Dana Van Gorder, Project Inform's executive director.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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