Making the decision to start therapy. On the level

In a field of unknowns, few topics are as unsettled as the subject of when to start anti-HIV treatment. The risk vs benefit equation of therapy has become more complicated as the drugs used to fight HIV and prolong life have been associated with bothersome and sometimes life-threatening adverse side effects (even though some of these effects may be only partly drug-related, or may be entirely due to other factors). When issues such as high drug costs, adherence challenges, and aversion to antiretroviral medication are considered, the notion of an optimal time to begin treatment becomes even more elusive. This article looks at the various issues and data related to starting versus delaying anti-HIV treatment.