The age and sex of the patient should be taken into account in deciding whether to initiate an anti-HIV treatment

Several demographic factors such as age and sex of the patient, should be taken into account in determining the conditions for initiation of antiretroviral therapy, shows a Greek study.
Viral load and the number of CD4 lymphotcytes markers being the most important predictions of the progression of HIV infection, clinical guidelines for initiating HAART are based on these two criteria. The decision to initiate treatment is based primarily on the number of CD4 and the threshold of 200 cells/mm3.

Giota Touloumi and colleagues at the Medical University of Athens wanted to know if sex, exposure group, age and year of seroconversion could also be markers of the evolution of the viral load.

The analysis of data from patients before starting treatment showed that the viral load decreased significantly during the first 10 months after seroconversion, then rises gradually.

Throughout the period before the initiation of treatment, women infected through sexual contact or during intravenous drug use showed an average viral load of 34% less than men in the same exposure group.

Among men, those infected through heterosexual contact and injection drug showed a viral load of less than 56% of homosexuals.
Older patients (over 40 years) also showed a higher than younger patients viral load.

"The levels of viral load at the same stage of HIV infection differ significantly between gender, risk group and age at seroconversion (...) It seems that these demographic characteristics should be considered before the initiation of treatment, "the authors conclude.

The lack of knowledge about the long-term impact of these criteria of gender, age group and does not encourage their routine use to decide the initiation of treatment, they point out, however. But these results suggest that it would be interesting to conduct further studies to confirm these findings and to identify the biological mechanisms underlying these differences and their clinical implications in determining the optimal time to begin treatment.