Guidelines Updated for Adults and Adolescents.(Guidelines for the Use of Antiretroviral Agents in HIV Infected Adults and Adolescents)

2001 FEB 22 - (NewsRx.com) -- An updated version of the Guidelines for the Use of Antiretroviral Agents in HIM Infected Adults and Adolescents, which includes revised recommendations for when to initiate anti-HIV therapy, was posted to the HIM/AIDS Treatment Information Service (ATIS) Web site (www.hivatis.org) on February 5, 2001.

The Guidelines were developed by the Panel on Clinical Practices for the Treatment of HIM Infection, a joint effort of the U.S. Department of Health and Human Services and the Henry J. Kaiser Family Foundation. Initially published in 1998, the Guidelines were constructed as a "living document" and are updated by the Panel as new data emerge.

"Although antiretroviral therapy has provided extraordinary benefits to many patients, we know that we cannot eradicate HIV infection with currently available medications," said Anthony S. Fauci, MD, U.S. National Institute of Allergy and Infectious Diseases (NIAID) and co-chair of the Panel. "We also recognize that serious toxicities are associated with the long-term use of antiretroviral drugs. The new treatment guidelines provide patients and their doctors with evidence-based recommendations for initiating antiretroviral therapy that take into account both the benefits and potential risks of currently available treatment regimens."

The new Guidelines recommend considering starting antiretroviral therapy when an asymptomatic HIV infected person's [CD4.sup.+] T-cell count falls below 350 cells per cubic millimeter ([mm.sup.3]); previous Guidelines recommended consideration of therapy for asymptomatic patients with a [CD4.sup.+] T-cell count lower than 500 cells/[mm.sup.3].

For asymptomatic HIV infected patients with [CD4.sup.+] T-cell counts higher than 350 cells/[mm.sup.3], treatment should be considered when the level of HIM in plasma is high [more than 30,000 copies per milliliter (ml) when using the branched DNA test, or more than 55,000 copies/ml when using the reverse transcriptase-polymerase chain reaction test]; previous Guidelines recommended consideration of therapy at lower levels of plasma HIV (10,000 copies/ml measured by branched DNA, or 20,000 copies/ml measured by RT-PCR). The Guidelines continue to recommend antiretroviral therapy for all patients with the acute HIM syndrome, those within six months of HIV seroconversion, and all patients with symptoms ascribed to HIV infection.

The Panel stresses that the Guidelines should be considered as a tool to help patients and their physicians make individual treatment decisions based on the best available information, but that much remains to be learned about how best to treat HIV infected ...