subject: Answers To Questions About Hiv Treatment Guidelines [print this page] Not too many years ago a collaboration of individuals and organisations in the USA put a document together to guide the treatment received byHIVpositive individuals as well as the decision made regarding the treatment of these individuals. This document was called the Guidelines for the Use of Antiretroviral Agents in HIV-Infected Adults and Adolescents. If you have HIV you may be wondering what your treatment is being based on and how decisions are made and how you can be involved in these decisions.
The Guidelines were developed in accordance with information garnered for a document entitled the Report of the NIH Panel to Define Principles of Therapy of HIV Infection which provided eleven principles based on scientific knowledge available at the time. Both of these documents are used to develop and implement treatment strategies for HIV positive patients.
The guidelines cover a number of key areas of treatment of HIV positive patients. These areas include: o The use of plasma testing for HIV RNA and CD4+ T cell counts as a guide for making decisions regarding treatment plans o The use of testing to establish whether there is, in fact, an HIV infection o The implementation of treatment for patients who are asymptomatic o The treatment of the advanced form of HIV infection, AIDS, as well as any special considerations that may need to be made o Guidelines for an interruption of the treatment o Criteria which must be met to validate a need for a change in therapy as well as alternative options for continued treatment o Treatment for HIV positive women who are also pregnant
The Guidelines recommend that treatment in HIV positive individuals be started as early on as possible with as aggressive a treatment regime as possible. It is also recommended that all medication be started simultaneously and that all medication be altered in the case of a failure of treatment to inhibit the chances of a drug resistant strain forming. Other recommendations include ensuring that at least three medications are used and that pregnant women are treated with intravenous zidovudine to attempt to prevent peri-natal transmission of the virus to the baby even if those women do not require antiretroviral treatment for themselves.
The Guidelines make use of a rating system indicating the strength of a particular treatment and the recommendation which should be used in conjunction with the treatment. This is to facilitate the inclusion of the patient in all treatment options. The patient should remain fully informed and included at all times. It is imperative that any treatment regime only be supervised by a qualified physician with experience in treating HIV positive patients as this experience can help to guide decisions and recommendations made. It should also be noted that the treatment of children for HIV is not included in these Guidelines as there are many complications which have to be considered when treating children. The document, though drafted in the late 1990's, is continually updated as further studies are conducted and more information comes to light.
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by: Pedro Banbury
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