December 7, 2009
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 Exclusive Interview: David Wohl, M.D., Summarizes Revised U.S. HIV/AIDS Treatment Guidelines

David Wohl, M.D.Looking for an expert summary of the latest revisions to the official U.S. HIV/AIDS treatment guidelines? Check out this exclusive interview with David Wohl, M.D., a prominent HIV physician/researcher and a member of the expert panel responsible for revising the guidelines. In this interview with's editorial director, Dr. Wohl walks us through the updated guidelines and explains the importance of the new revisions. His summary is concise and easy to understand. A more lengthy, technical interview will be available soon! (Article and podcast from

We've summarized the main changes to the guidelines in an article or you can read about them below!

  • Earlier Treatment Recommended: For people who have never been on HIV meds before, treatment is now recommended at a CD4 count of 500 or less (up from 350 or less).
  • Is There Such a Thing as Starting Meds "Too Early"? The expert panel was split over whether people should begin HIV treatment at a CD4 count above 500. Half felt it was a good idea; the other half felt it was OK to consider it, but that a person should carefully weigh the pluses and minuses with their doctor first.
  • What to Start With: There are now four specific regimens that are considered "preferred" for first-line treatment:
    • Atripla
    • Isentress and Truvada
    • Norvir, Prezista and Truvada
    • Norvir, Reyataz and Truvada
    Non-preferred first-line regimens are now split into various lists ("alternative," "acceptable," etc.) that include brief explanations for why it may or may not be wise to try them.
  • Kaletra Demoted: Kaletra has been removed from the list of "preferred" first-line HIV meds; it's now generally considered an "alternative" medication, mainly because it carries a heightened risk for gastrointestinal side effects and high lipid levels. That said, the twice-daily dose of Kaletra is still a recommended medication for HIV-positive pregnant women.

Feel free to comment on these changes on our guidelines summary page; browse the panel's official listing of the revisions; or download the guidelines in their entirety (as a 168-page PDF file).

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