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HIV Treatment Guidelines

HIV Treatment Guidelines - New Guidelines

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Updated December 13, 2009

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The panel on Antiretroviral Guidelines for Adults and Adolescents, a part of the Department of Health and Human Services has also issued new HIV treatment guidelines. Let's take a look at these HIV treatment guidelines that update those guidelines established in November 2008.

Drug Resistance Testing

As part of the new HIV treatment guidelines, genotypic testing is the preferred drug resistance test. However, in cases of complex drug resistance issues, phenotypic testing should also be considered.

Initiation of HIV Treatment

  • Treatment should be started in all people with AIDS defining illnesses or with a CD4 count of 350 or less.

  • In pregnant women, people with HIV kidney disease, and hepatitis B needing hepatitis treatment, HIV treatment should be started.
  • There is mixed opinion on starting HIV treatment in people with CD4 counts from 350 to 500 and in people with CD4 counts above 500. In fact, the panel that develops the HIV treatment guidelines are split 50-50 over whether treatment should begin when CD4 counts are above 350.

    What Drugs Should be Used

    As is the case with the WHO HIV treatment guidelines, recommended therapies are based on a growing pool of clinical trial data proving a regimen's efficacy and durability. As new medications and regimens are developed older regimens are moved from preferred to alternative status. The trend is for the most "patient-friendly" regimens that offer the fewest side effects with the greatest chance of adherence and therefore success.

    Sources

    DHHS Panel on Antiretroviral Guidelines for Adults and Adolescents; "Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents"; 1 Dec 2009.

    World Health Organization; "New HIV recommendations to improve health, reduce infections and save lives."; 30 Nov 2009.

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