TITLE

Management of HIV infection in treatment-naive patients: A review of the most current recommendations

AUTHOR(S)
Boyd, Sarita D.
PUB. DATE
June 2011
SOURCE
American Journal of Health-System Pharmacy;6/1/2011, Vol. 68 Issue 11, p991
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Purpose. The most current guidelines issued by the Department of Health and Human Services (DHHS) on the management of human immunodeficiency virus (HIV) infection in treatment-naive patients are reviewed. Summary. Treatment guidelines are updated frequently because of the emergence of data demonstrating the risks and benefits of antiretroviral therapy. The DHHS guidelines strongly recommend initiating therapy in patients with certain conditions regardless of CD4 cell count and in patients with CD4 cell counts of <350 cells/mm3. Although supporting data are less definitive, treatment is also recommended for patients with CD4 cell counts of 350-500 cells/mm3. Treatment for patients with CD4 cell counts of >500 cells/ mm3 is controversial. Although cumulative observational data and biological evidence support treatment at higher CD4 cell counts, randomized controlled trial data to support this are not available, and the risk of antiretroviral toxicities, resistance, nonadherence, and cost should be considered in individual patients. The preferred regimens have been consolidated to four options, including a dual-nucleoside reverse transcriptase inhibitor backbone (tenofovir plus emtricitabine) with a nonnucleoside reverse transcriptase inhibitor (efavirenz), a ritonavir-boosted protease inhibitor (atazanavir plus ritonavir or darunavir plus ritonavir), or an integrase strand-transfer inhibitor (raltegravir). Regimens are classified as alternative or acceptable when they have potential safety or efficacy concerns, have higher pill burdens, or require more frequent administration compared with preferred regimens. Conclusion. The DHHS 2011 guidelines advocate earlier antiretroviral therapy initiation than recommended in recent years, and preferred regimens have been refined to maximize efficacy, safety, and quality of life for treatment-naive HIV-infected patients.
ACCESSION #
61141718

 

Related Articles

  • United States Buys More Flu Medication.  // Clinical Infectious Diseases;7/1/2009, Vol. 49 Issue 1, pi 

    The article reports on the plan of the U.S. to buy courses of flu medications worth 13 million. According to Kathleen Sebelius, secretary of U.S. Health and Human Services, the medications will replenish to the nation's stockpile to ensure the need treatment of the Americans. It informs that the...

  • Digests. Poor User Adherence May Explain Lack of Efficacy In HIV Prophylaxis Trial. Melhado, L. // International Perspectives on Sexual & Reproductive Health;Jun2015, Vol. 41 Issue 2, p113 

    The article offers information on randomized, placebo-controlled trial which found that daily prophylactic treatment with tenofir-based regimens did not reduce the risk of HIV acquisition among women at high risk for the infection. Topics include the eligibility of women for the trial,...

  • Antiviral Briefs.  // AIDS Patient Care & STDs;Jun99, Vol. 13 Issue 6, p375 

    Reports on developments in antiviral treatments against HIV and AIDS. Includes the United States and Canadian health authorities' approval of 3TC and efivirenz; Efficacy of antiviral agent HE2000 in lowering viral load; Triple-drug regimen of lamivudine, zidovudine and ritonavir to clear HIV...

  • A Fusion Inhibitor (FP-21399) for the Treatment of Human Immunodeficiency Virus Infection: A Phase I Study. Dezube, Bruce J.; Dahl, Thomas A.; Wong, Thomas K.; Chapman, Beryl; Ono, Mitsunori; Yamaguchi, Naoto; Gillies, Stephen D.; Lan Bo Chen; Crumpacker, Clyde S. // Journal of Infectious Diseases;8/1/2000, Vol. 182 Issue 2 

    Examines the risk for preventable opportunistic infections (Pneumocystis carinii pneumonia and Mycobacterium avium for persons with AIDS. Analysis on the effect of antiretroviral therapy for AIDS patients; Application of the counting-process formulation of the Cox model; Considerations for the...

  • Influenza-related pneumonia. DIGNAN, FERGUS // Clinical Medicine;Jun2012, Vol. 12 Issue 3, p299 

    A letter to the editor is presented in response to the article "Influenza-related Pneumonia," by Wise and colleagues in the February 2012 issue.

  • Risk of Opportunistic Infection in the HAART Era Among HIV-Infected Latinos Born in the United States Compared to Latinos Born in Mexico and Central America. Wohl, Amy Rock; Lu, Sharon; Turner, Jane; Kovacs, Andrea; Witt, Mallory; Squires, Kathleen; Towner, William; Beer, Victor // AIDS Patient Care & STDs;Jun2003, Vol. 17 Issue 6, p267 

    There are few studies that compare opportunistic infection (OI) rates for U.S.-born, Mexican-born, and Central American-born Latinos in the pre- or post-highly active antiretroviral therapy (HAART) era. Data on 803 Latino persons in treatment for HIV infection in Los Angeles, California, were...

  • A Family Group Approach to Increasing Adherence to Therapy in HIV-Infected Youths: Results of a Pilot Project. Lyon, Maureen E.; Trexler, Connie; Akpan-Townsend, Carleen; Pao, Maryland; Selden, Keith; Fletcher, Jean; Addlestone, Irene C.; D'Angelo, Lawrence J. // AIDS Patient Care & STDs;Jun2003, Vol. 17 Issue 6, p299 

    This paper describes the development of a novel, pilot program in which a combined family group and peer approach were used to increase adherence to antiretroviral therapy in HIV-infected youths. Twenty-three HIV-positive youths, 15-22 years of age and 23 family members or "treatment buddies"...

  • Report: PrEP effective with just a few doses, but no new strategies. SIMONETTE, MATT // Windy City Times;7/30/2014, Vol. 29 Issue 44, p8 

    The article talks about a study published in the journal "The Lancet Infectious Diseases" that reveals the 90 percent chances of HIV infection reduction by taking as few as two or three doses of Pre-Exposure Prophlaxis or PrEP a week while taking four or more doses offers a 100-percent reduction.

  • Hepatitis C in HIV-Infected Patients: Impact of Direct-Acting Antivirals. Bichoupan, Kian; Dieterich, Douglas // Drugs;Jun2014, Vol. 74 Issue 9, p951 

    Approximately 30 % of HIV-infected patients are co-infected with hepatitis C virus (HCV). After the release of highly active antiretroviral therapy, liver disease has become the leading cause of morbidity and mortality in HIV patients. Prior to 2011, HCV treatment with pegylated-interferon and...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

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

Try another library?
Sign out of this library

Other Topics