Latest US antiretroviral guidelines

Published: 05 March 2001

The US Department of Health and Human Services guidelines on the use of

anti-retrovirals in adults have been revised again to take into account newly

published data. One major change is the inclusion for the first time of an NNRTI

(efavirenz) in the proposed ‘preferred’ first-line drug combinations – previous

versions of the guidelines have advised the use of protease inhibitor-based

combinations only.

It is suggested that drug resistance tests in ‘pre-treatment screening’ may

be useful where regional prevalence of drug resistance amongst the newly

infected is above 5-10%. In people who begin treatment it may be appropriate,

say the guidelines’ authors, to measure viral load within two weeks of starting

in order to check the response to treatment. Common practice in the UK is to do

a first viral load test after around two months of starting a new treatment.

The full US guidelines can be downloaded at