Expert panel issues new HIV guidelines
September 1, 1997
Expert panel issues new HIV guidelines
The message: Hit early, hit hard
Studies showing the effectiveness of the new antiretroviral drugs prompted an international panel of AIDS experts to release new guidelines for HIV management. The following is a summary of the panel’s recommendations, which were presented at the recent International AIDS Conference in Vancouver, BC, and published in the Journal of the American Medical Association.1 Notable changes include:
• Patients should begin antiretroviral therapy earlier in the course of their disease. Treatment goal should be reducing viral load below detectable levels.
• Monitoring of viral load levels should be continuous throughout treatment.
• The most effective initial antiretroviral treatment is a three-drug regimen that includes two nucleoside analogs and one potent protease inhibitor. This three-drug regimen should be taken early and continued indefinitely.
• Physicians should recommend a treatment strategy that takes into account the patient’s commitment and ability to adhere to a strict drug regimen. (For more on medication adherence, see story, p. 154.)
• Therapy should be changed if viral load levels increase, the patient suffers toxic effects or drug intolerance, or the patient fails to adhere to the treatment regimen.
Reference
Charles CJ, Carpenter MD, Fischl MA, et al. Antiretro-viral therapy for HIV infection in 1997. JAMA 1997; 277: 1,962-1,969.
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