U.S. Treatment Guidelines Updated

The U.S. Department of Health and Human Services on October 29 released revisions to its guidelines for antiretroviral treatment of HIV-positive adults and adolescents. One of the changes relates to when to begin treatment based on blood-based viral levels. The previous recommendation for asymptomatic patients was to begin therapy when viral levels climbed above 55,000 copies per milliter of blood; the new guidelines say to wait until viral load tops 100,000 copies. The guidelines also shifted the anti-HIV drug Zerit from 'preferred' to 'alternate' status; labeled Viread plus either Epivir or Emtriva as a recommended two nucleoside reverse transcriptase inhibitor-based backbone; and indicated that Emtriva is now an option as a preferred or alternative choice for a two-NNRTI backbone. The revisions also remove all comments about hydroxyurea, since it is not an antiretroviral agent.