What are the DHHS guidelines on antiretroviral therapy (ART) for early symptomatic HIV infection?

Updated: Jan 02, 2019
  • Author: Robert J Carpenter, DO, AAHIVS, FACP; Chief Editor: John Bartlett, MD  more...
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Answer

Answer

Current Guidelines for the Use of Antiretroviral Agents in HIV-1–Infected Adults and Adolescents, published by US Department of Health and Human Services, recommend starting antiretroviral therapy for all individuals when infection is diagnosed, regardless of stage of infection, as long as barriers to therapy do not exist. Considerations are as follows:

  • The goal of treatment should be the suppression of plasma HIV RNA to below detectable levels

  • Testing for plasma HIV RNA levels and CD4 count and toxicity monitoring should be performed

  • If therapy is initiated before drug-resistance test results are available, a ritonavir-boosted protease inhibitor–based regimen should be used, because clinically significant resistance to protease inhibitors is less common than resistance to non-nucleoside reverse transcriptase inhibitors in antiretroviral therapy–naive persons who harbor drug-resistant virus

For discussion of antiretroviral drugs and regimens, see Antiretroviral Therapy for HIV Infection.


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