New Adult Treatment Guidelines Are Released

The Department of Health and Human Services has released revised HIV treatment guidelines for adolescents and adults that include a major shift in how antiretroviral medications are recommended to treat HIV disease. Previous guidelines listed anti-HIV drugs in two columns and recommended that doctors craft an antiretroviral regimen by combining one drug from the first column with one choice from the second column, which typically grouped anti-HIV drugs in pairs. But with 22 single and combination anti-HIV medications now available, health experts deemed the column format too confusing and replaced it with a simpler list of 'preferred' and 'alternate' drug combinations. The preferred first combinations include a nonnucleoside reverse transcriptase inhibitor'based regimen containing Sustiva and Epivir plus a third choice among Retrovir, Viread, or Zerit; there is also a protease inhibitor'based regimen that recommends Kaletra, Epivir, and either Retrovir or Zerit. The guidelines also include information on drug adherence, medications not recommended for treatment-naive patients, best regimens for pregnant women, salvage therapy, drug interactions, and which supplements and other medications to avoid when taking anti-HIV drugs. 'These guidelines help simplify the process by which caregivers and patients chart a course of therapy, whether they are receiving antiretroviral treatment for the first time or are contemplating a change in drug regimen,' says Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.