Latest US antiretroviral guidelines

This article is more than 24 years old.

The US Department of Health and Human Services guidelines on the use of

anti-retrovirals in adults have been revised again to take into account newly

published data. One major change is the inclusion for the first time of an NNRTI

Glossary

drug resistance

A drug-resistant HIV strain is one which is less susceptible to the effects of one or more anti-HIV drugs because of an accumulation of HIV mutations in its genotype. Resistance can be the result of a poor adherence to treatment or of transmission of an already resistant virus.

first-line therapy

The regimen used when starting treatment for the first time.

(efavirenz) in the proposed ‘preferred’ first-line drug combinations – previous

versions of the guidelines have advised the use of protease inhibitor-based

combinations only.

It is suggested that drug resistance tests in ‘pre-treatment screening’ may

be useful where regional prevalence of drug resistance amongst the newly

infected is above 5-10%. In people who begin treatment it may be appropriate,

say the guidelines’ authors, to measure viral load within two weeks of starting

in order to check the response to treatment. Common practice in the UK is to do

a first viral load test after around two months of starting a new treatment.

The full US guidelines can be downloaded at

href="http://www.hivatis.org">http://www.hivatis.org