Important note: Information in this article was accurate in January 2007. The state of the art may have changed since the publication date.
U.S. Public Health Service Guideline Changes
Hopkins HIV Report 2007 Jan; 19(1):6
John G. Bartlett, M.D.
Johns Hopkins
There were recent changes in the U.S Public Health Service HIV guidelines. The key changes are summarized below.
Public Health Service Task Force Recommendations for Use of Antiretroviral Drugs in Pregnant HIV-1-Infected Women for Maternal Health and Interventions to Reduce Perinatal HIV-1 Transmission in the United States - October 12, 2006
The major change is the updated recommendations for the use of antiretroviral drugs in pregnancy:
| Nucleosides/tide analog reverse transcriptase inhibitors (NRTIs) | |||
| Recommended: | Alternatives: | Inadequate data: | Not recommended: | • zidovudine • lamivudine |
• didanosine • emtricitabine • stavudine • abacavir |
• tenofovir | • zalcitabine |
| Non-nucleoside reverse transcriptase inhibitors (NNRTIs) | |
| Recommended: nevirapine (use with baseline CD4 > 250/mm3 only if benefit clearly outweighs the risk of hepatotoxicity) | Not recommended: efavirenz (avoid in first trimester; use after 2nd trimester can be considered if alternatives are not available and adequate contraception can be assured postpartum). |
| Protease Inhibitors | ||
Recommended:
|
Alternative agents:
|
Inadequate data:
|
| Fusion Inhibitors Inadequate data: enfuvirtide |
Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents - October 10, 2006
The major change is recommendations for initial regimens in treatment-naïve patients. Select either an NNRTI or a PI from column A (NRTI or PI) plus one dual-NRTI combination from column B.
| Column A | + | Column B | |||
| NNRTI | OR | PI | Dual-NRTI | ||
| Preferred Components in alphabetical order |
efavirenz |
|
|
||
| Alternative to Preferred in alphabetical order |
nevirapine |
|
|
||
2007-01-10
HHR-2007-01-03
Copyright © 2007 - The Johns Hopkins University AIDS Service, Division of Infectious Diseases. Permission to use and reproduce portions of this newsletter is hereby granted provided that author and publication are fully credited and both copyright and permission notice appear with reprinted material. Inquiries may be directed to Sharon McAvinue, Managing Editor. Website: Johns Hopkins AIDS Service.
Organizations providing financial support do not participate in the editorial process or otherwise influence editorial decisions. The information presented in The Hopkins HIV Report represents the standards of care of the Johns Hopkins AIDS Service. Every effort is made to ensure the timeliness and accuracy of information presented in this newsletter, but standards of care change rapidly; therefore, the authors, editors, and publisher will not in any way be held liable for the timeliness of information or for errors, omissions, or inaccuracies in this publication. Readers should review carefully the product information contained in manufacturers’ package inserts for any drug mentioned in this publication; mention of products does not constitute endorsement.
AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from Boehringer Ingelheim, Bridgestone/Firestone Charitable Trust, Bristol-Myers Squibb Company, Elton John AIDS Foundation, Gill Foundation, the National Library of Medicine, Quest Diagnostics, Roche and Trimeris, and donations from users like you.
AEGiS 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 ©1980,2008. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.