IAS USA Update Adult ARV Treatment Guidelines

An update of the International Antiviral Society-USA (IAS-USA) recommendations for adult HIV treatment as an open access article in the Journal of the American Medical Association (JAMA).

The document is written by an international panel of doctors and the update is based on a systematic review of conference presentations and published research from the previous two years.

Changes since the previous edition include:

• Offering ART to all patients regardless of CD4 cell count.
• Changes in therapeutic options (including both tenofovir/FTC and abacavir/3TC as first-line background nucleoside analogues).
• Recognising the protective benefit of treatment in reducing the risk of transmission.
• Cited new evidence that untreated HIV can also lead to a range of other conditions, including cardiovascular disease and kidney disease, and some cancers.
• Modifications in the timing and choice of ART in the setting of opportunistic illnesses such as cryptococcal disease and tuberculosis.

Comment

These guidelines are a significantly briefer document that the US DHHS guidelines which has a far more significant reach and influence.

Although criteria for membership of the panel includes not participating in pharmaceutical industry sponsorship, this is only for the duration of the period on the panel. As with most treatment guidelines, extensive conflicts of interest are declared for most if not all panel members.

Reference

1. Antiretroviral Treatment of Adult HIV Infection 2012: Recommendations of the International Antiviral Society–USA Panel. JAMA. 2012;308(4):387-402. (25 July 2012).