HCV:
The Correctional Conundrum
(continued)
Current Recommendations
for Initiating Antiretroviral Therapy
In February 2001, the Panel
on Clinical Practices for Treatment of HIV Infection convened by the Department
of Health and Human Services (HHS) revised its guidelines for the use of
antiretroviral agents in adults (see HEPP News, February 2001).6
The most recent change in the HHS guidelines are the recommendations regarding
initiation of therapy in the asymptomatic HIV-infected patient, which were
summarized in the February 2001 issue of HEPP News. (It must be noted that
these recommendations apply only to chronically infected patient, not to
patients with acute HIV infection). The recommendation to wait for
a CD4 count of <350 or a viral load of >50,000 by PCR ñi.e., more advanced
infectionñ is in reaction to the greater appreciation of the adverse metabolic
effects of long term antiretroviral therapy. Adverse effects can
be seen with all the classes of agents currently available, and for most
people with HIV infection, therapy will be continued lifelong. Thus, the
new HHS guidelines recommend delaying initiation of therapy until the risk
of disease progression justifies the risk of antiretroviral therapy. However,
there is reason to believe these guidelines will be modified again this
year due to new information on gender differences in viral loads.
CONTINUE...
|
|
|
