Key Points in the Guidelines for the Treatment of HIV-Infected Adults and Teenagers

With all of the study and research being done in the field of HIV treatment and prevention more treatment options have become available. This has led to the need for a treatment guideline to be drafted and established as common practice to ensure that all HIV patients undergoing treatment receive the best possible care. Here is a look at some of the key points of the guidelines proposed in the USA in 1997 for the treatment of HIV positive adults and adolescents.

Testing

o All decisions regarding the start or changing of antiretroviral treatment must be guided through the use of testing to monitor the viral load of the patient o This should be supplemented by the CD4+ T cell count and clinical condition of the patient o Testing should take place every three to four months. For more information on hiv insurance, go to http://www.aidslifequote.co.za

Treating an established infection

o All patients with AIDS or symptomatic HIV infection should be given antiretroviral treatment o CD4+ T cell counts lower than 500 or with evidence of more than 10000 copies of HIV RNA according to the bdna test or 20000 copies according to the RT-PCR test should be offered the option of beginning therapy o The decision to treat low viral counts in patients with CD4+ T cell counts rests with the physician o A treatment consisting of two nucleoside reverse transcriptase inhibitors and one protease inhibitor is recommended o The substitution of nevirapine for the protease inhibitor is possible but not optimal o If there is any reason to cease antiretroviral medication then all medication should be stopped. Partial continued administration of the treatment is not recommended due to the possibility of resistant strains emerging

Considerations for changing the treatment

o It must be established whether the therapy is to be discontinued due to drug failure or as a result of drug toxicity o Alternative drug substitution is recommended in the case of drug toxicity o At least two medications must be changed in the case of drug failure o Treatment should only be changed with full patient consent o The criteria for changing treatment methods must be met before any change is initiated

Treatment of an acute infection

o HIV infection is always treated as a suspect in any patient which presents with a number of the symptoms of HIV infection, which are similar to the flu o Antiretroviral treatment should only be administered to those patients with HIV infection o Aggressive treatment is recommended for maximum effect o All medications should be started simultaneously o Treatment should be continued indefinitely

It is apparent that these guidelines should be sufficient to bring about some level of conformity to the treatment procedures for HIV positive patients. The establishment of guidelines such as these will undoubtedly increase the level of care given to such patients and is recommended for all countries with any level of HIV infection. This may be problematic for developing countries, but governments worldwide should still make an effort to put guidelines such as these in place.

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