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Guidelines for the Use of Antiretroviral Agents in HIV-Infected Adults and Adolescents

US Health & Human Services, December 1998


Conclusion

The panel has attempted to use the advances in our understanding of the pathogenesis of HIV in the infected person to translate scientific principles and data obtained from clinical experience into recommendations that can be used by the clinician and patient to make therapeutic decisions. The recommendations are offered in the context of an ongoing dialogue between the patient and the clinician after having defined specific therapeutic goals with an acknowledgment of uncertainties. It is necessary for the patient to be entered into a continuum of medical care and services, including social, psychosocial, and nutritional services, with the availability of expert referral and consultation. In order to achieve the maximal flexibility in tailoring therapy to each patient over the duration of his or her infection, it is imperative that drug formularies allow for all FDA-approved NRTI, NNRTI, and PI as treatment options. The Panel strongly urges industry and the public/private sectors to conduct further studies to allow refinement of these guidelines. Specifically, studies are needed to optimize recommendations for first line therapy; to define second line therapy; and to more clearly delineate the reason(s) for treatment failure. The Panel remains committed to revising their recommendations as such new data become available.

Information included in these guidelines may not represent FDA approval or approved labeling for the particular products or indications in question. Specifically, the terms "safe" and "effective" may not be synonymous with the FDA-defined legal standards for product approval.

Conteúdo
Summary

Introduction

Use of Testing for Plasma HIV RNA Levels and CD4+ T Cell Count in Guiding Decisions for Therapy

Established Infection

Interruption of Antiretroviral Therapy

Considerations for Changing a Failing Regimen

Acute HIV Infection

Considerations for Antiretroviral Therapy in the HIV-Infected Adolescent

Considerations for Antiretroviral Therapy in the HIV-Infected Pregnant Woman

Conclusion

References

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