Advertisement
Advertisement


News

U.S. HIV Treatment Guidelines Strengthen Recommendations for Treatment Irrespective of CD4 Count

January 30, 2016

On 29 January 2016, the leading U.S. HIV treatment guidelines were updated online, strengthening the recommendation for early treatment.1

The main changes are to increase the rating for using ART irrespective of CD4 count to the highest A1 (strongest recommendation based on highest quality of scientific evidence). This change was based on results from the START and TEMPRANO studies.2,3

The recommendations are similarly strengthened (also to A1) for people diagnosed in early infection, noting "earlier ART initiation may result in less residual immune dysfunction during treatment, which theoretically may result in reduced risk of disease for decades to come."

While recognising some circumstances where treatment might be deferred the guidelines broad view access to treatment as an essential right for all patients, including irrespective of mental health, substance use and psychological issues.

Advertisement

The main recommendations are listed below.

  • ART is recommended for all HIV positive individuals, regardless of CD4 cell count, to reduce the 
morbidity and mortality associated with HIV infection (AI).
  • ART is also recommended for HIV positive individuals to prevent HIV transmission (AI).
  • When initiating ART, it is important to educate patients on the benefits and considerations regarding ART, and to address strategies to optimize adherence. On a case-by-case basis, ART may be deferred because of clinical and/or psychosocial factors, but therapy should be initiated as soon as possible.
  • Antiretroviral therapy (ART) is recommended for all individuals with HIV-1 infection (AI) including those with early HIV-1 infection.
  • ART is especially important for older patients because they have a greater risk of serious non-AIDS complications and potentially a blunted immunologic response to ART.
  • The fixed-dose combination of elvitegravir/cobicistat/tenofovir alafenamide/FTC is included as a new preferred first-line option.


References

  1. U.S. Department of Health and Human Services (HHS) Panel on Antiretroviral Guidelines for Adults and Adolescents. January 2016.
    Download PDF
  2. The INSIGHT START Study Group. Initiation of antiretroviral therapy in early asymptomatic infection. NEJM (20 July 2015). DOI: 10.1056/NEJMoa1506816.
  3. The TEMPRANO ANRS 12136 Study Group. A trial of early antiretrovirals and isoniazid preventive therapy in Africa. N Engl J Med 2015; 373:808-822. (27 August 2015). DOI: 10.1056/NEJMoa1507198.


Related Stories

What's New in the U.S. HHS Antiretroviral Therapy Guidelines for Adults and Adolescents
Guideline on When to Start Antiretroviral Therapy and on Pre-Exposure Prophylaxis for HIV
Read the Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents (PDF)



This article was provided by HIV i-Base. Visit HIV i-Base's website to find out more about their activities, publications and services.
 

Reader Comments:

Comment by: Richard Byaruhanga (Nairobi) Fri., Feb. 5, 2016 at 9:37 am UTC
Thank you for this information and we appreciate to the ARV,S therapy medication , i believe that there is another alternative way of how to improve it to do work better even to kick out the Virus if more scientific medication brains are added in exploring more ways on this wonderful Drug . As i have hard from my friends doctors say about the Leukemia therapy and treatment shows that there is a little left to get an HIV cure .
Reply to this comment


Add Your Comment:
(Please note: Your name and comment will be public, and may even show up in
Internet search results. Be careful when providing personal information! Before
adding your comment, please read TheBody.com's Comment Policy.)

Your Name:


Your Location:

(ex: San Francisco, CA)

Your Comment:

Characters remaining:

Advertisement

The content on this page is free of advertiser influence and was produced by our editorial team. See our content and advertising policies.