Treatment guidelines

Treatment guidelines features

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  Treatment as prevention: Experts in the UK agree it works

  Roger Pebody summarises the statement released in January that should now guide how our doctors talk to us about treatment as prevention. ...

  From:  HIV treatment update

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  The bottom line in clinical care: The new BHIVA standards

  Gus Cairns summarises this important new document. ...

  From:  HIV treatment update

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  The generic generation

  In the next few years, some of the most widely used HIV drugs will come off patent in the UK. Gus Cairns asks: what are the...

  From:  HIV treatment update

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  Treatment: what really works best?

  The new edition of the HIV treatment guidelines from the British HIV Association (BHIVA) is now out for public consultation. HTU editor Gus Cairns was one of the...

  From:  HIV treatment update

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  Help when you're troubled: getting the right psychological support

  Gus Cairns looks at the new Standards for psychological support for adults living with HIV....

  From:  HIV treatment update

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  HIV drug prescribing in London: changes from this month

  From April 2011, the preferred first- and second-line drug regimens for HIV-positive people in London are changing. The change in prescribing practice will not initially affect people...

  From:  HIV treatment update

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  WHO issues updated TB treatment guidelines

  Treatment regimens for tuberculosis should include an antibiotic of the rifamycin class for the full six months of therapy, according to new World Health Organization...

  From:  HIV & AIDS treatment in practice

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  Guidelines, which guidelines?

  HTU editor Gus Cairns investigates HIV treatment guidelines. ...

  From:  HIV treatment update

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  New WHO treatment guidelines

  This issues covers new WHO guidelines on when to start treatment, the phase out of stavudine, PMTCTand infant feeding and the policy change in South Africa. ...

  From:  HIV & AIDS treatment in practice

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  PLHIV provide recommendations for revision of ART guidelines

  During Summer 2009 GNP+ identified key recommendations for the revision of the World Health Organisation’s Recommendations for Antiretroviral Therapy (ART) for HIV Infection in Adults...

  From:  HIV & AIDS treatment in practice

Treatment guidelines news from aidsmap

• Malawi achieves seven-fold increase in ART for pregnant and breastfeeding women

  Eighteen months after implementation of 'Option B+' in Malawi – ART for life for all HIV-infected, pregnant or breastfeeding women regardless of CD4 count or disease stage – the number of HIV-infected pregnant women on ART increased dramatically ...

  12 March 2013 | Carole Leach-Lemens

• Second-line NRTI-sparing regimen proves equally effective for resource-limited settings

  A second-line antiretroviral regimen of lopinavir/ritonavir (Kaletra/Aluvia) and raltegravir (Isentress) proved just as effective as a regimen containing lopinavir/ritonavir and two or three nucleoside or nucleotide analogues in large study conducted in Australia, Africa, Latin America and Asia, researchers ...

  07 March 2013 | Keith Alcorn

• AIDS-defining illnesses, especially TB, more frequent at high CD4 counts in Africa and Asia

  Rates of death and illness remained 'substantial' even at higher CD4 cell counts among people receiving antiretroviral therapy in lower-income settings, and much greater efforts to get people onto treatment earlier will be needed to reduce this burden in people ...

  07 February 2013 | Carole Leach-Lemens

• UK experts: successful treatment is "as effective as consistent condom use" in reducing HIV transmission

  The British HIV Association (BHIVA) and the Department of Health’s Expert Advisory Group on AIDS (EAGA) published this week a position statement on the use of HIV treatment by people with HIV to reduce the risk of transmission. For ...

  23 January 2013 | Roger Pebody

• Nigeria: Drug resistance data show merits of using tenofovir in first-line ART regimens

  People living with HIV in Nigeria, at high risk for virological failure, on a tenofovir (TDF)-based first-line regimen, had fewer nucleoside reverse transcriptase inhibitor (NRTI) drug-resistant mutations and more fully active NRTI drug options for second-line treatment, researchers report ...

  23 January 2013 | Carole Leach-Lemens

• Low-dose stavudine study debated between South African researchers and activists

  A proposed trial of low-dose stavudine (also known as d4T) sparked a heated debate between South African researchers and activists at the opening of the first Southern African HIV Clinicians' Society Conference held in Cape Town last month. Professor ...

  11 December 2012 | Lesley Odendal

• Swiss research identifies factors associated with use of non-recommended HIV therapy

  New Swiss research shows the importance of observing antiretroviral treatment guidelines, even in people who have well-controlled HIV infection. Published in the online edition of the Journal of Acquired Immune Deficiency Syndromes, the study demonstrated that toxicities and concerns ...

  05 December 2012 | Michael Carter

• Abacavir: new studies challenge the evidence of reduced potency when viral load is high

  An analysis of two studies of the new HIV integrase inhibitor dolutegravir presented at the Eleventh International Congress on Drug Therapy in HIV Infection in Glasgow had the incidental effect of bringing into question evidence from a previous study ...

  26 November 2012 | Gus Cairns

• Death rates elevated at all CD4 counts below 500 in sub-Saharan Africa

  A comparison of death rates between the HIV-positive and HIV-negative partners in serodiscordant couples in sub-Saharan Africa has found significantly higher death rates in people with HIV with CD4 counts below 500, suggesting that expanding treatment beyond eligibility thresholds ...

  06 November 2012 | Keith Alcorn

• ART for life cost effective for prevention of mother-to-child transmission in Uganda

  Combination antiretroviral therapy (ART) provided to all pregnant women with HIV who have CD4 cell counts under 350 cells/mm3 (World Health Organization Option B) in Uganda appears to be highly cost effective for the prevention of mother-to-child transmission (PMTCT), even ...

  18 September 2012 | Carole Leach-Lemens

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Treatment guidelines news selected from other sources

• Postexposure Prophylaxis: Dealing With Old Guidelines

  The patient responded, “With all due respect to the guidelines, in the current era when there are increasingly well-tolerated medications, why would you use a regimen that included only 2 NRTIs without a third drug in any setting where there is a risk of HIV transmission?”

  13 March 2013 | Clinical Care Options (requires registration)

• Program to Cut HIV Transfer to Babies Gets High Marks

  The African nation of Malawi is getting an A+ for its aggressive approach to preventing HIV transmission from mothers to babies.

  02 March 2013 | MedPage Today HIV/AIDS

• When to Start ART in Africa — An Urgent Research Priority

  We believe that a randomized, controlled trial should be undertaken immediately to determine when to initiate ART in Africa for maximal individual health benefit. It is feasible to conduct a large, simple trial to assess the risks and benefits of immediate ART versus deferral until a CD4+ count of 350 cells per cubic millimeter is reached.

  23 February 2013 | New England Journal of Medicine

• Why no one is helped by dumbing down the “when to start” debate: a response to Dr Myron Cohen

  This article was prompted by contributions to the “when to start” debate that avoid both it’s complexity and the lack of evidence for benefits at higher CD4 counts. This issue has broad concern for HIV positive people, doctors and health workers, and public health policy.

  23 February 2013 | HIV i-Base

• Updated HIV Treatment Guidelines Include Stronger Recommendation for Acute Infection

  Among the key changes are additional information about the most recently approved antiretroviral agents and a recommendation that newly infected people with HIV should be offered combination ART. The guidelines continue to recommend treatment for all people with HIV, both to reduce the risk of disease progressionand for the prevention of HIV transmission.

  15 February 2013 | HIVandHepatitis.com

• Updated U.S. DHHS guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents

  New recommendations on drug-resistance testing, genotypic tropism assays, starting treatment, acute infection, pregnancy and interactions.

  15 February 2013 | AIDSinfo

• UK: Updated guidance on HIV transmission, the law and the work of the clinical team now published

  This document is aimed at those working in HIV medicine, especially clinicians, and aims to provide information and guidance on managing issues related to sexual transmission of HIV. It applies generic ethical and professional principles but with a particular emphasis on providing a confidential environment in which sensitive matters can be discussed. The guidance sets out the roles and responsibilities of health care professionals when caring for individuals living with HIV.

  13 February 2013 | HIV Justice Network

• Uganda: Health Ministry Sets New Treatment Guidelines

  The health ministry has released new national clinical guidelines for the management of common conditions. It also released new essential medicines and health supplies list for HIV/AIDS, malaria, TB, pneumonia and diarrhoea in children.

  01 February 2013 | AllAfrica

• 2012 European guideline on the diagnosis and treatment of gonorrhoea in adults recommends dual antimicrobial therapy

  The recommended treatment for uncomplicated Neisseria gonorrhoeae infections of the urethra, cervix, rectum and pharynx, when the antimicrobial sensitivity is unknown, is a combination of ceftriaxone 500 mg and azithromycin 2 g.

  22 November 2012 | Eurosurveillance

• Phase out D4T in poor countries

  D4T used to be prescribed at 40mg but was reduced to 30mg to reduce side-effects. But even at this reduced dose many patients cannot tolerate it. So do we really need a new study to look at a lower dose (20 mg) of D4T than the current one? Many people living with HIV around the world feel that we do not and that we should plan to phase out this drug completely as has been done in Europe and the United States.

  07 November 2012 | Quackdown

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