Guidelines for ART Updated for Those With or at Risk for HIV

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ART recommended for almost all HIV-infected; should be initiated as soon as possible post diagnosis.

HealthDay News — Recommendations for antiretroviral therapy (ART) have been updated for individuals at risk of or living with HIV; the 2018 recommendations of the International Antiviral Society-USA Panel are published in the July 24/31 issue of the Journal of the American Medical Association.

Michael S. Saag, M.D., from the University of Alabama at Birmingham, and colleagues developed new update recommendations for 2018 using evidence collected since the International Antiviral Society-USA 2016 recommendations.

The authors note that for almost all HIV-infected individuals, ART is recommended as soon as possible after HIV diagnosis. For initial therapy, an integrase strand transfer inhibitor plus two nucleoside reverse transcriptase inhibitors is generally recommended; the treatment choice should be guided by unique patient circumstances. At specified points before and during ART, CD4 cell count, HIV RNA level, genotype, and other laboratory tests for general health and coinfection are recommended. Treatment history, tolerability, adherence, and drug resistance history should be assessed if a regimen switch is indicated; for a new regimen, two or three active drugs are recommended. For anyone who has ever been sexually active, HIV testing is recommended at least once, and testing is recommended more often for those at ongoing risk for infection. For individuals at risk for HIV, preexposure prophylaxis with tenofovir disoproxil fumarate/emtricitabine and appropriate monitoring are recommended.

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“Advances in HIV prevention and treatment with antiretroviral drugs continue to improve clinical management and outcomes for individuals at risk for and living with HIV,” the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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