Treatment for Adult HIV Infection

作者：Scott M. Hammer, Michael S. Saag, Mauro Schechter, Joan Montaner, Robert T. Schooley, Donna M. Jacobsen, Melanie Ann Thompson, Charles C. J. Carpenter, Margaret A. Fischl, Brian Gazzard, José M. Gatell, Martin Hirsch, David Allan Katzenstein, Douglas D. Richman, Stefano Vella, Patrick Yéni, Paul A. Volberding · 发表于：JAMA · 年份：2006 · DOI：10.1001/jama.296.7.827 · 被引用次数：1037 · 研究领域：HIV/AIDS drug development and treatment、HIV/AIDS Research and Interventions、HIV Research and Treatment

CONTEXT: Guidelines for antiretroviral therapy are important for clinicians worldwide given the complexity of the field and the varied clinical situations in which these agents are used. The International AIDS Society-USA panel has updated its recommendations as warranted by new developments in the field. OBJECTIVE: To provide physicians and other human immunodeficiency virus (HIV) clinicians with current recommendations for the use of antiretroviral therapy in HIV-infected adults in circumstances for which there is relatively unrestricted access to drugs and monitoring tools. The recommendations are centered on 4 key issues: when to start antiretroviral therapy; what to start; when to change; and what to change. Antiretroviral therapy in special circumstances is also described. DATA SOURCES AND STUDY SELECTION: A 16-member noncompensated panel was appointed, based on expertise in HIV research and patient care internationally. Data published or presented at selected scientific conferences from mid 2004 through May 2006 were identified and reviewed by all members of the panel. DATA EXTRACTION AND SYNTHESIS: Data that might change previous guidelines were identified and reviewed. New guidelines were drafted by a writing committee and reviewed by the entire panel. CONCLUSIONS: Antiretroviral therapy in adults continues to evolve rapidly, making delivery of state-of-the-art care challenging. Initiation of therapy continues to be recommended in all symptomatic persons and in asymp...