BETHESDA, MdNewly updated guidelines for treating HIV-infected
adults and adolescents are now available and include recommendations
for the use of recently developed tests that help determine whether
the virus carried by a patient has become resistant to one or more
The revised Guidelines for the Use of Antiretroviral Agents in
HIV-Infected Adults and Adolescents also contains a new section
on the goals of HIV therapy, and the version available on the
Internet includes a hypertext link to detailed information about
using antiretrovirals in treating pregnant women.
The guidelines, a joint effort by the Department of Health and Human
Services and the Henry J. Kaiser Family Foundation, were originally
published in 1998.
The number of treatment options for HIV-infected individuals
has increased dramatically, making decisions regarding therapy more
and more complex, Anthony S. Fauci, MD, director of the
National Institute of Allergy and Infectious Diseases, said in a
press release. The new guidelines, based on the latest
available research findings, provide recommendations on how to
optimally use the many antiretroviral medications and sophisticated
laboratory tests now available to people living with HIV.
In the therapy goals section, the revised guidelines acknowledge that
it is probably impossible to eradicate an HIV infection with
currently available treatments. Instead, it emphasizes other primary
goals for retroviral therapy. These include the restoration and/or
preservation of the patients immunologic function; an
improvement in the individuals quality of life; and the
reduction of HIV-related illness and death. To achieve these goals,
the guidelines suggest maximizing patient adherence to a regimen;
selecting user-friendly regimens whenever possible; prescribing drugs
in a rational sequence in order to preserve future treatment options;
and using drug resistance assays when treatment fails.
These tests can help to explain the reasons for treatment
failure and guide the rational selection of a new drug regimen,
said John G. Bartlett, MD, of Johns Hopkins University, co-chairman
of the guideline-revisions panel.