The Department of Health and Human Services updated its Guidelines for the use of antiretroviral therapy in HIV-1-infected Children, adults and adolescents to reflect the findings obtained from the START and EARLY studies that demonstrate the benefits over the clinical picture of people who had an early antiretroviral therapy (ART) with a pre-treatment of these patients, even in those with CD4 cell counts and above 500 cells / mm3.
Results of the START study were first announced in May last year and presented at the International AIDS Society Conference in July of 2015. Participants in the trials with CD4 cell counts above 500 cells / mm3 were randomly assigned to start treatment immediately or wait until their CD4 cell counts therapies dropped below 350 cells / mm3 or when they develop symptoms of AIDS.
The study showed that people in the immediate treatment group were 57% less likely to experience an outcome with serious non-AIDS-related events related to AIDS and death compared to deferred therapy groups. People treated early have not only had a lower 72 risk of suffering from AIDS-related events, but also a reduction of 39% in non-AIDS events, including cancer!
The findings of the TEMPRANO study presented at last year's conference on retroviruses and opportunistic infections also showed that the onset of ART in a CD4 count above 500 cells / mm3 reduced the risk of severe disease and death compared to the beginning of delayed treatment.
The main changes to the guidelines
- The DHHS panel increased the strength and qualification test for "A1" for the recommendation that all people diagnosed with HIV should start the art regardless of the CD4 count.
- The recommendation for initiation of treatment for patients diagnosed with acute or recent HIV infection has been reinforced, also given an "A1" classification.
- Although adolescents have not been included in the START or TEMPRANO study, the panel decided the recommendation to treat all patients with HIV should include them; the panel recommends that adolescent post-puberty should be treated according to adult guidelines and that pre-pubertal children should be treated according to pediatric guidelines.
The panel reinforced its emphasis on immediate treatment for older adults living with HIV, as they are at increased risk of serious non-AIDS complications and a potentially blunted immune response to ART.
In November of 2015 the panel added the newly approved Genvoya formulation - the first scheme to contain the "new" (the quotation marks are from the publisher) and safer tenofovir alafenamide (TAF) - as a recommended option for first-line treatment.
Complete and up-to-date guidelines are available online athttps://aidsinfo.nih.gov/guidelines. The panel welcomes feedback on revised guidelines until 12 February 2016 (send to ContactUs@aidsinfo.nih.gov).
Written by Liz Highleyman. Translated by Cláudio Souza on the 05 / 02 / 2016 night of the original in DUpdated Antiretroviral Therapy Guidelines Emphasize Benefits of Early HIV Treatment Review, Mara Macedo.
Panel on HHS antiretroviral guidelines for adults and adolescents. Guidelines for the use of antiretroviral therapy in HIV-infected Children-1 adults and adolescents (opens in another site, in English - I promise to translate). January 28 of 2016.
Aidsinfo. Adult HHS and adolescents up-to-date antiretroviral treatment guidelines released. Press office. January 28 of 2016.
anguished note Soropositivo.org editor | Yes, I know. These studies are needed. I just wonder if it is necessary that there are deaths, and these dead people are transformed into statistical data. Although I have not infirm connection with any NGO and no commitment to any laboratory (The site is maintained with my money and my job) I question the medical ethics that studies lives and stratifies deaths "a greater good".
How many of us still have to die in order to reach to a vaccine or a cure. Because the Gilead squeezed Tenofovir to the penny before launching Genoya and how often it will still be done.
Alvíssaras, you are now known and have not lived moments like me, of "therapeutic vacations" and that now I feel injured in life time and quality of life for something that today can only be seen as a huge monstrosity and a fierce lust in holding back. You will have a better and longer life. Remember to come to our fields, to deposit flowers and some tablets. And, if possible, a prayer too.