TITLE

Treatment for Adult HIV Infection

AUTHOR(S)
Hammer, Scott M.; Saag, Michael S.; Schechter, Mauro; Montaner, Julio S.G.; Schooley, Robert T.; Jacobsen, Donna M.; Thompson, Melanie A.; Carpenter, Charles C.J.; Fischl, Margaret A.; Gazzard, Brian G.; Gatell, Jose M.; Hirsch, Martin S.; Katzenstein, David A.; Richman, Douglas D.; Vella, Stefano; Yeni, Patrick G.; Volberding, Paul A.
PUB. DATE
August 2006
SOURCE
JAMA: Journal of the American Medical Association;8/16/2006, Vol. 296 Issue 7, p827
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Context Guidelines for antiretroviral therapy are important for clinicians worldwide given the complexity of the field and the varied clinical situations in which these agents are used. The International AIDS Society-USA panel has updated its recommendations as warranted by new developments in the field. Objective To provide physicians and other human immunodeficiency virus (HIV) clinicians with current recommendations for the use of antiretroviral therapy in HIV- infected adults in circumstances for which there is relatively unrestricted access to drugs and monitoring tools. The recommendations are centered on 4 key issues: when to start antiretroviral therapy; what to start; when to change; and what to change. Antiretroviral therapy in special circumstances is also described. Data Sources and Study Selection A 16-member noncompensated panel was appointed, based on expertise in HIV research and patient care internationally. Data published or presented at selected scientific conferences from mid 2004 through May 2006 were identified and reviewed by all members of the panel. Data Extraction and Synthesis Data that might change previous guidelines were identified and reviewed. New guidelines were drafted by a writing committee and reviewed by the entire panel. Conclusions Antiretroviral therapy in adults continues to evolve rapidly, making delivery of state-of-the-art care challenging. Initiation of therapy continues to be recommended in all symptomatic persons and in asymptomatic persons after the CD4 cell count falls below 350/µL and before it declines to 200/µL. A nonnucleoside reverse transcriptase inhibitor or a protease inhibitor boosted with low-dose ritonavir each combined with 2 nucleoside (or nucleotide) reverse transcriptase inhibitors is recommended with choice being based on the individual patient profile. Therapy should be changed when toxicity or intolerance mandate it or when treatment failure is documented. The virologic target for patients with treatment failure is now a plasma HIV-1 RNA level below 50 copies/mL. Adherence to antiretroviral therapy in the short-term and the long-term is crucial for treatment success and must be continually reinforced.
ACCESSION #
21943144

 

Related Articles

  • Cohort Profile: Standardized Management of Antiretroviral Therapy Cohort (MASTER Cohort). Torti, Carlo; Raffetti, Elena; Donato, Francesco; Castelli, Francesco; Maggiolo, Franco; Angarano, Gioacchino; Mazzotta, Francesco; Gori, Andrea; Sighinolfi, Laura; Pan, Angelo; Cauda, Roberto; Scalzini, Alfredo; Quiros-Roldan, Eugenia; Nasta, Paola; Gregis, Giampietro; Benatti, Simone; Digiambenedetto, Simona; Ladisa, Nicoletta; Giralda, Mariarosaria; Saracino, Annalisa // International Journal of Epidemiology;Apr2017, Vol. 46 Issue 2, p1 

    No abstract available.

  • HIV Prevention for a Threatened Continent. Bunnell, Rebecca; Mermin, Jonathan; De Cock, Kevin M. // JAMA: Journal of the American Medical Association;8/16/2006, Vol. 296 Issue 7, p855 

    The article discusses the development of HIV prevention programs in Africa. The prevalence of HIV infections in sub-Saharan Africa is estimated as of 2005. HIV prevention programs are described, including counseling, HIV testing, and antiretroviral therapy (ART) for HIV-positive persons. The...

  • Assessment of hematological adverse drug reactions to antiretroviral therapy in HIV positive patients at Kasturba Hospital Manipal. Pulagam, Poornima; Rajesh, Radhakrishnan; Vidyasagar, Sudha; Varma, Danturulu Muralidhar // BMC Infectious Diseases;2012 Supplement, Vol. 12 Issue Supplment 1, p1 

    The article presents a study on the hematological adverse drug reactions (ADRs) associated with highly active antiretroviral therapy in HIV positive patients in India. The authors investigate the casuality, incidence rate and severity pattern of hematological ADRs among HIV patients. The study...

  • Prevalence of depressive symptoms amongst highly active antiretroviral therapy (HAART) patients in AIDSRelief Uganda. Shumba, Constance; Atukunda, Ruth; Imakit, Richard; Memiah, Peter // Journal of Public Health in Africa;2013, Vol. 4 Issue 2, p84 

    There is limited data on the prevalence of depression in HIV and AIDS patients in Sub- Saharan Africa and little resources have been allocated to address this issue. Depression affects patient adherence to treatment and predisposes patients to resistance which poses a public health threat. It...

  • Factors associated with adherence to antiretroviral therapy in HIV-infected patients in Kathmandu District, Nepal. Shigdel, Rajesh; Klouman, Elise; Bhandari, Anita; Ahmed, Luai A. // HIV/AIDS - Research & Palliative Care;2014, Vol. 6, p109 

    Purpose: There are a high number of HIV-infected patients receiving antiretroviral therapy (ART) in the Kathmandu District of Nepal, but information on adherence and factors influencing it are scarce in this population. The present study aimed to estimate ART adherence among HIV-infected...

  • Physiotherapy intervention as a complementary treatment for people living with HIV/AIDS. Pullen, Sara D.; Chigbo, Nnenna Nina; Nwigwe, Emmanuel Chukwudi; Chukwuka, Chinwe J.; Amah, Christopher Chim; Idu, Stanley C. // HIV/AIDS - Research & Palliative Care;2014, Vol. 6, p99 

    Background: The advent of highly active antiretroviral therapy has dramatically extended the life expectancy of people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome. Despite this increased longevity, HIV disease and its pharmacological treatment can cause...

  • Determinants of Mortality and Loss to Follow-Up among Adults Enrolled in HIV Care Services in Rwanda. Mugisha, Veronicah; Teasdale, Chloe A.; Wang, Chunhui; Lahuerta, Maria; Nuwagaba-Biribonwoha, Harriet; Tayebwa, Edwin; Ingabire, Eugenie; Ingabire, Pacifique; Sahabo, Ruben; Twyman, Peter; Abrams, Elaine J. // PLoS ONE;Jan2014, Vol. 9 Issue 1, p1 

    Background: Antiretroviral therapy (ART) improves morbidity and mortality in patients with HIV, however high rates of loss to follow-up (LTF) and mortality have been documented in HIV care and treatment programs. Methods: We analyzed routinely-collected data on HIV-infected patients ≥15...

  • Clinical Trials in Sub-Saharan Africa and Established Standards of Care: A Systematic Review of HIV, Tuberculosis, and Malaria Trials. Kent, David M.; Mwamburi, D. Mkaya; Bennish, Michael L.; Kupelnick, Bruce; Ioannidis, John P. A. // JAMA: Journal of the American Medical Association;7/14/2004, Vol. 292 Issue 2, p237 

    Context The minimum standard of care required for participants in clinical trials conducted in resource-poor settings is a matter of controversy; international documents offer contradictory guidance. Objective To determine whether recently published trials conducted in sub-Saharan Africa met...

  • Managing Medicare's HIV Caseload in the Era of Suppressive Therapy. Gilden, David E.; Kubisiak, Joanna M.; Gilden, Daniel M. // American Journal of Public Health;Jun2007, Vol. 97 Issue 6, p1053 

    Objectives. The 1996 introduction of antiretroviral medications changed Medicare's role in providing HIV care. We analyzed Medicare's patient database in an effort to document the new HIV therapies' effects on expenditures and outcomes. Methods. We examined the medical billing records of a 5%...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics