Updated AIDS Treatment Guidelines Offer More Switching Flexibility
This article was originally published in The Pink Sheet Daily
Executive Summary
Clinical advances are making it more possible to personalize HIV regimens and even to safely switch drugs, according to updated treatment guidelines presented by the International AIDS Society-USA Panel
|
Clinical advances are making it more possible to personalize HIV regimens and even to safely switch drugs, according to updated treatment guidelines presented by the International AIDS Society-USA Panel. The panel presented the guidelines Aug. 13 at the International AIDS Conference in Toronto. Their advice to physicians for treating HIV-infected adults was last updated in 2004. Their recommendations as to when antiretroviral therapy should start - when CD4 cell count dips below 350/ul but before it reaches 200/ul - has not changed. The initial recommended regimen also remains a combination of two nucleoside (or nucleotide) reverse transcriptase inhibitors with either a nonnucleoside reverse transcriptase inhibitor or a protease inhibitor boosted with low-dose ritonavir. "Given the high degree of comparability of the recommended components of these regimens in treatment-naive persons with drug-susceptible virus," however, the choice of drug centers on a number of factors. Those factors include a combination of acceptability; predicted tolerance; pill burden; comorbid conditions; short-term, mid-term, and long-term adverse event profiles; and successful alternatives should the initial regimen fail, the panel says. Therapy should be changed when toxicity or intolerance mandate it or when treatment failure occurs, but the goal of maintaining a plasma HIV-1 RNA count below 50 copies/ml, "is now achievable in a substantial proportion of patients," they note. -Shirley Haley |