HIV Treatment Guidelines
Table of Contents
Some of the important updates in the most recent version of the US Department of Health and Human Service's (DHHS) guidelines for the treatment of HIV in adults and adolescents are listed here:
More information on updates to the treatment guidelines is included below.
A branch of the US government, called the Department of Health and Human Services, (DHHS), has put together a set of HIV treatment guidelines. The guidelines provide a lot of useful information to help health care providers and people living with HIV make decisions about when to start, when to stop, and when to change HIV medications. It also helps providers and HIV+ people choose among the many available HIV drugs.
The guidelines are written and reviewed regularly by a group of HIV experts, including researchers, health care providers, and community activists. They were first published in 1998 and have been updated many times since then. The most recent guidelines were released in February 2013. The full version of the guidelines is available at http://aidsinfo.nih.gov/contentfiles/AdultandAdolescentGL.pdf.
Some of the topics the guidelines cover are listed below.
The World Health Organization (WHO) released new HIV treatment guidelines in June 2013 at the International AIDS conference in Malaysia. The WHO recommends that HIV drugs be offered to all those living with HIV whose CD4 count is less than 500. It also recommends that HIV drugs be offered to certain groups as soon as they test positive for HIV:
The guidelines also recommend using viral load tests instead of CD4 counts to see how HIV drugs are working.
The guidelines describe the goals of HIV treatment. They are basically to keep you as healthy and as well as possible using the best care and treatment available today. The goals are the same for people just starting treatment and those who have been on treatment for a long time:
There has been a lot of discussion and debate about when to start treatment over the years. The guidelines have been changed a number of times. Some earlier versions recommended that people wait longer before starting HIV treatment. This was because of concerns about the HIV drugs, such as side effects and difficult dosing schedules. It was thought that HIV was not as harmful as possible drug side effects in people with higher CD4 counts.
There is now more proof that untreated HIV is bad for your health at all stages of disease. Several large studies have shown that people who begin treatment early have a better outcome than those who wait to start treatment until their HIV has progressed. Also, the drug combinations now available are easier to take and have fewer side effects than older regimens. For these reasons the newest guidelines recommend starting earlier.
The current US guidelines state:
[Note: Because the panel's expert opinion is not based on results from randomized controlled trials, which are often considered the 'gold standard' for providing evidence, there is some debate about the DHHS panel's recommendation to begin treatment with a CD4 count above 500. In other words, while some experts agree that the current level and quality of evidence supports treatment above 500, other experts do not.]
Because starting medication is such an important decision, the guidelines suggest considering more than just your CD4 count and viral load. It is important to think about whether you are ready to start and able to take your medications as prescribed. You and your health care provider should consider the risks and benefits of starting treatment earlier or later.
Potential Benefits of Starting Therapy Early
Potential Risks of Starting Therapy Early
This article was provided by The Well Project. Visit The Well Project's Web site to learn more about their resources and initiatives for women living with HIV. The Well Project shares its content with TheBody.com to ensure all people have access to the highest quality treatment information available. The Well Project receives no advertising revenue from TheBody.com or the advertisers on this site. No advertiser on this site has any editorial input into The Well Project's content.
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