Treatment of AIDS and HIV-Related Conditions: 2001
Treatment of AIDS and HIV-Related Conditions: 2001
Managing human immunodeficiency virus (HIV) disease and the acquired immunodeficiency syndrome (AIDS) has become more standardized yet more complex during the past year. Antiretroviral treatment guidelines now represent a general consensus on basic treatment principles and options as benefits and risks of therapy have become more evident. Clinical manifestations of HIV infection, prognosis, and quality of life are clearly improved for most patients receiving potent antiretroviral therapy, yet viral resistance and chronic and short-term drug toxicities remain major problems. The markedly decreased incidence of opportunistic infections among treated patients has made unusual infections less common in daily HIV management. The role of resistance assays in HIV care is still being assessed, but they offer great possibilities for improving our ability to find satisfactory antiretroviral regimens when others have failed. Finally, for the patient and the primary care clinician, the universal challenges of maintaining adherence to complicated medication regimens and avoiding toxicities and drug-drug interactions remain enormous obstacles.
Excellent HIV care requires applying the principles of primary care, family care, and chronic care management with knowledge and experience in managing HIV infection. Multidisciplinary team collaboration among primary care clinicians, pharmacists, case workers, nurses, and AIDS experts can offer the best opportunity to provide comprehensive care.
This Current Report--HIV updates our annual treatment guidelines. These recommendations (Table 1) are based on our experience at San Francisco General Hospital, published guidelines, a review of the medical literature, and experience gained from answering telephone calls to our National HIV Telephone Consultation Service (Warmline). Because HIV management changes rapidly, clinicians are advised to refer to the excellent federal guidelines for the use of antiretroviral agents in HIV-infected adults and adolescents and for prevention of opportunistic infections, which are updated frequently on the Internet (Table 2). These and other federal guidelines are available at http://www.hivatis.org.
Managing human immunodeficiency virus (HIV) disease and the acquired immunodeficiency syndrome (AIDS) has become more standardized yet more complex during the past year. Antiretroviral treatment guidelines now represent a general consensus on basic treatment principles and options as benefits and risks of therapy have become more evident. Clinical manifestations of HIV infection, prognosis, and quality of life are clearly improved for most patients receiving potent antiretroviral therapy, yet viral resistance and chronic and short-term drug toxicities remain major problems. The markedly decreased incidence of opportunistic infections among treated patients has made unusual infections less common in daily HIV management. The role of resistance assays in HIV care is still being assessed, but they offer great possibilities for improving our ability to find satisfactory antiretroviral regimens when others have failed. Finally, for the patient and the primary care clinician, the universal challenges of maintaining adherence to complicated medication regimens and avoiding toxicities and drug-drug interactions remain enormous obstacles.
Excellent HIV care requires applying the principles of primary care, family care, and chronic care management with knowledge and experience in managing HIV infection. Multidisciplinary team collaboration among primary care clinicians, pharmacists, case workers, nurses, and AIDS experts can offer the best opportunity to provide comprehensive care.
This Current Report--HIV updates our annual treatment guidelines. These recommendations (Table 1) are based on our experience at San Francisco General Hospital, published guidelines, a review of the medical literature, and experience gained from answering telephone calls to our National HIV Telephone Consultation Service (Warmline). Because HIV management changes rapidly, clinicians are advised to refer to the excellent federal guidelines for the use of antiretroviral agents in HIV-infected adults and adolescents and for prevention of opportunistic infections, which are updated frequently on the Internet (Table 2). These and other federal guidelines are available at http://www.hivatis.org.