What are the DHHS guidelines for initiation of antiretroviral therapy (ART) for HIV infection?

Updated: Oct 08, 2019
  • Author: Nicholas John Bennett, MBBCh, PhD, MA(Cantab), FAAP; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Current Department of Health and Human Services (DHHS) guidelines on the timing of initiation of antiretroviral therapy are as follows [5] :

  • Antiretroviral therapy should be initiated in all patients with a history of an AIDS-defining illness or with a CD4 count below 350/µL

  • Antiretroviral therapy should be initiated regardless of CD4 count in pregnant patients, patients with HIV-associated nephropathy, and those with hepatitis B virus (HBV) coinfection when treatment of HBV infection is indicated

  • Panel divided on initiation of therapy with CD4 counts of 350-500/µL; 55% considered this a strong recommendation, 45% considered it a moderate recommendation

  • Panel also divided on initiation of therapy with CD4 counts above 500/µL: half favored initiation in this setting, and half considered treatment initiation optional


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