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
(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