Revised U.S. Adult and Adolescent Antiretroviral Treatment Guidelines; also Revised Pediatric Guidelines.Small but important revisions to the U.S. Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents were published in a revised document on November 10, 2003. The latest HIV HIV (Human Immunodeficiency Virus), either of two closely related retroviruses that invade T-helper lymphocytes and are responsible for AIDS. There are two types of HIV: HIV-1 and HIV-2. HIV-1 is responsible for the vast majority of AIDS in the United States. treatment guidelines are always available at: http://www.aidsinfo.nih.gov/guidelines/ The revised guidelines include warnings against two three-drug NRT NRT Nicotine Replacement Therapy NRT Norm-Referenced Test NRT near real time NRT Non-Real-Time NRT National Response Team NRT Tokyo, Japan - Narita (Airport Code) NRT Net Registered Tonnage ! combinations that should never be used as a triple regimen (abacavir + tenofovir + lamivudine, and tenofovir + didanosine didanosine /di·dan·o·sine/ (-dan´o-sen) 2, an analogue of dideoxyadenosine; an antiretroviral agent used for the treatment of advanced HIV-1 infection and acquired immunodeficiency syndrome, administered orally. + lamivudine), because these regimens failed to control viral load in treatment-naive volunteers in recent clinical trials, leading to development of viral resistance in some patients. The problem with these regimens is well known--but unless the warning is in the guidelines, some physicians with little HIV experience may make a mistake. The warning against combining d4T + ddl (stavudine plus didanosine) due to risk of toxicities now clearly applies not only in pregnancy but to anyone (unless the benefits outweigh the risks for a particular patient). The previous edition of the guidelines had been criticized for being ambiguous on this. The revised guidelines warn against combining atazanavir + indinavir indinavir /in·di·na·vir/ (in-di´nah-vir) an HIV protease inhibitor that causes formation of immature, noninfectious viral particles; used as the sulfate salt in the treatment of HIV infection and AIDS. (possible worse hyperbilirubinemia), and FTC FTC See Federal Trade Commission (FTC). + 3TC (similar resistance profile, without additional benefit). And they also include additional information on T-20 (enfuvirtide). Atazanavir and FTC have been added to the guidelines as potential alternative drugs in certain regimens. (The new guidelines also make it clear that "alternative" recommendations can be the preferred treatment for some patients.) This edition includes a helpful "What's New in This Document?" section just after the cover page. Patients who want to check to see how their treatment compares should note that much of the information is in the tables at the end of the document. Remember that HIV-expert physicians may have good reason for not following the guidelines in some cases. Pediatric pediatric /pe·di·at·ric/ (pe?de-at´rik) pertaining to the health of children. pe·di·at·ric adj. Of or relating to pediatrics. HIV Guidelines Revised A revised Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection was published November 26, 2003, by the U.S. Department of Health and Human Services Noun 1. Department of Health and Human Services - the United States federal department that administers all federal programs dealing with health and welfare; created in 1979 Health and Human Services, HHS . It is also available at the U.S. government Web site for official HIV treatment and related guidelines: http://www.aidsinfo.nih.gov/guidelines/ |
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