AIDS TREATMENT NEWS Issue #361, February 28, 2001
John S. James
The new GUIDELINES FOR THE USE OF ANTIRETROVIRAL AGENTS IN HIV-INFECTED ADULTS AND ADOLESCENTS were released February 5; they are available at many Web sites, but the official site for all the U.S. Department of Health and Human Services HIV treatment guidelines is the HIV/AIDS Treatment Information Service, http://www.hivatis.org
For a printed copy, you can call 800-448-0440, or mail a request to HIV/AIDS Treatment Information Service, P.O. Box 6303, Rockville, MD 20849-6303. Note: it will probably take the office 7-10 days to ship a printed copy of the guidelines -- in addition to the time required for mail delivery. Be sure to ask for the adult guidelines if that is what you want, as there are currently five different HIV guidelines available (see below).
The official Web site (http://www.hivatis.org) also has a separate copy of the new adult guidelines with changes highlighted in yellow, so you can see what is different from the last version.
When we checked this site in March 2001, the guidelines could either be viewed while online or printed; however, we were unable to save a copy of the file for viewing on the computer when not connected to the Internet. A dial-up (low speed) connection did work OK for viewing. When we checked, the HTML (Web) format version had a summary of the changes, which was not included in the PDF format or printed document.
The most prominent change is that the new guidelines are more conservative about when to start treatment.
"In general, treatment should be offered to individuals with fewer than 350 CD4+ T cells/mm3 or plasma HIV RNA levels exceeding 30,000 copies/mL (bDNA assay) or 55,000 copies/mL (RT-PCR assay). The strength of the recommendation to treat asymptomatic patients should be based on the willingness and readiness of the individual to begin therapy; the degree of existing immunodeficiency as determined by the CD4+ T cell count; the risk of disease progression as determined by the CD4+ T cell count and level of plasma HIV RNA; the potential benefits and risks of initiating therapy in asymptomatic individuals; and the likelihood, after counseling and education, of adherence to the prescribed treatment regimen." (From the Summary. This discussion does not apply to all patients -- see the full Summary.)
There is also a new section in this edition of the adult treatment guidelines, "Considerations for Antiretroviral Therapy in Women."
Since most HIV physicians were already treating in accordance with the new guidelines even before their publication, this recommendation is not expected to change HIV practice very much. More important to day-by-day medical care will be the extensive practical information for physicians, which has been provided in 24 tables in the document. The guidelines committee presented this information as tables because members thought physicians would be more likely to use it in that form than if presented as text.
Besides the adult guidelines, the HIV/AIDS Treatment Information Service can send current guidelines on:
The office also has other patient education material.
The HIV/AIDS Treatment Information Service can answer individual questions, either by phone or by postal mail address above, or by email to atis@hivatis.org. It can provide information from its database, but of course cannot give medical advice.
010228
ATN36102
Copyright © 2001 - AIDS Treatment News. Permission granted for noncommercial reproduction, provided that our address and phone number are included if more than short quotations are used. Subscription lists are kept confidential. AIDS Treatment News, Subscription and Editorial Office: 1233 Locust St., 5th floor Philadelphia, PA 19107 800/TREAT-1-2 toll-free email: aidsnews@critpath.org http://www.aidsnews.org
Subscription Information: Call 800/TREAT-1-2: Businesses, Institutions, Professionals: $270/year. Includes early delivery of an extra copy by email. Nonprofit organizations: $135/year. Includes early delivery of an extra copy by email. Individuals: $120/year, or $70 for six months. Special discount for persons with financial difficulties: $54/year, or $30 for six months. If you cannot afford a subscription, please write or call. Outside North, Central, or South America, add air mail postage: $20/year, $10 for six months. Back issues available. Fax subscriptions, bulk rates, and multiple subscriptions are available; contact our office for details. Please send U.S. funds: personal check or bank draft, international postal money order, or travelers checks. VISA, Mastercard, and purchase orders also accepted. ISSN # 1052-4207
ÆGiS is made possible through unrestricted grants from Boehringer Ingelheim, iMetrikus, Inc., the National Library of Medicine, and donations from users like you. Always watch for outdated information. This article first appeared in 2001. This material is designed to support, not replace, the relationship that exists between you and your doctor.
ÆGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.
Copyright ©1990, 2000. ÆGiS & the Sisters of Saint Elizabeth of Hungary. All materials appearing on ÆGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of ÆGIS and the Sisters of Saint. Elizabeth of Hungary, or the party credited as the provider of the content.