New guidelines on how to treat adults with HIV have been published following developments in treatment.
Experts say to maintain a high standard of care in a rapidly changing field such as antiretroviral therapy, treatment guidelines must be regularly revised.
Due to the availability of new antiretroviral drugs and formulations, as well as recent data on treatment options for antiretroviral patients, Dr Scott Hammer from the Columbia University College of Physicians and Surgeons in the US and the International AIDS Society-USA Panel have published a new set of recommendations.
The study, in the Journal of the American Medical Association (Jama), recommends that therapy should begin before CD4 cell count falls below 350/ÂµL. It also suggests that other factors should be taken into account, including a falling CD4 cell count, and the existence of other diseases that may affect treatment such as active hepatitis B or C.
The research says that individualised antiretroviral treatment is essential, especially because other illnesses and infections may affect a therapy’s efficacy, and highlights the need for constant monitoring of plasma HIV-1 RNA levels.
The authors also point out drugs have now been approved that can be added to regimens to keep HIV suppressed even when strengthened by multidrug resistant virus.
The study concludes: “With creativity and political will, the progress and individualised approach to antiretroviral therapy evident in the developed world can be adapted to the public health approach in the developing world, where 90% of the world’s HIV-infected population lives.”
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