New HIV guidelines recommend delaying use of powerful drugs

From Medical Correspondent Christy Feig

CHICAGO, Illinois (CNN) -- New guidelines on when to begin treatment for HIV, the virus that causes AIDS, recommend delaying use of powerful medications in patients who are not showing symptoms of a weakened immune system.

The revised guidelines are a change from the original "hit hard, hit early" approach, which taught doctors and patients to attack the virus with multiple drugs as soon after infection as possible.

That approach was "put together with the thought in mind that there might be the possibility of ultimately eradicating the virus and therefore ultimately stop therapy," said Dr. Anthony Fauci, co-chairman of the Panel on Clinical Practices for the Treatment of HIV Infection, which decided on the recommended treatment guidelines.

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The revised guidelines come as the Eighth Annual Retrovirus Conference meets this week in Chicago. The conference will attract the world's top experts on AIDS to discuss new treatments and ways to deliver the drugs to the estimated 36 million people worldwide infected with AIDS virus.

The panel issuing the new guidelines is a part of the Department of Health and Human Services and the Henry J. Kaiser Family Foundation, which worked jointly on the guidelines.

While the drugs have proven to be effective at suppressing HIV, they also have toxic side effects, such as liver abnormalities, increased cholesterol, and thinning of bones. The virus also mutates around the drugs, making the virus resistant to medicines over time.

With a limited number of drugs available and the patients' need to take them for life, the guidelines also show that experts have recognized the importance of saving the medicines for when they are really needed.

The revised guidelines also include new recommendations for specific drugs. They include a newer protease inhibitor called Kaletra, or a combination of ritonavir, a protease inhibitor approved in 1996, with another protease inhibitor called indinavir.

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Physicians' Research Network
Thebody.com: AIDS information resource
MayoClinic.com - AIDS
Journal of the American Medical Association: HIV/AIDS information
AIDS Internet Information Gateway
National AIDS Treatment Advocacy Project: Conferences: HIV/AIDS Treatment Information

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