U.S. Antiretroviral Therapy Guidelines
July 5, 2014
We keep learning more about the best way to fight HIV. In 1998, the US Department of Health and Human Services created a panel of physicians, researchers, and consumers to develop treatment guidelines. They constantly review AIDS research results. The guidelines are updated about once each year. The panel released the latest guidelines in May 2014.
Note: These are guidelines, not rules. Patients should receive individualized care from a health care provider with experience treating HIV infection. The full text of these guidelines is available on the Internet at www.aidsinfo.nih.gov/; choose "Guidelines."
Viral load and CD4 cell tests provide critical information for decisions on antiretroviral therapy (ART). Before changing treatment, the tests should be repeated to confirm the results. Fact Sheet 124 has more information on CD4 cell tests and Fact Sheet 125 covers viral load testing.
Viral load should be tested:
CD4 cell counts should be done:
Viral resistance testing helps health care providers choose the most effective drugs. See Fact Sheet 126 for more information. Resistance testing is recommended for patients starting therapy, when viral load is not controlled by new medications, or when it "breaks through" a regimen that used to work. The guidelines recommend resistance testing before starting antiretroviral treatment (ART). It can also make sense for people who don't need to start ART yet. This can show if the person got infected with drug-resistant virus.
Other Laboratory Tests
The guidelines recommend using a viral tropism test (see Fact Sheet 129) before starting therapy with a CCR5 inhibitor. They also suggest using a genetic test, HLA-B*5701 before starting abacavir (see Fact Sheet 416).
Starting HIV Treatment With a CD4 Count Between 350-499 Lowers Mortality Risk and Disease Progression
This article was provided by AIDS InfoNet. Visit AIDS InfoNet's website to find out more about their activities and publications.