{"id":11916,"date":"2003-10-01T15:00:11","date_gmt":"2003-10-01T15:00:11","guid":{"rendered":"http:\/\/i-base.info\/htb\/?p=11916"},"modified":"2014-05-27T11:03:37","modified_gmt":"2014-05-27T11:03:37","slug":"british-2003-hiv-treatment-guidelines-are-published-online","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/11916","title":{"rendered":"British 2003 HIV treatment guidelines are published online"},"content":{"rendered":"<p><strong>Simon Collins, HIV i-Base<\/strong><\/p>\n<p><strong>The British HIV Association (BHIVA) has published the 2003 UK treatment guidelines online in both html and pdf file format.<\/strong><\/p>\n<p><a href=\"http:\/\/www.bhiva.org\/\">http:\/\/www.bhiva.org\/<\/a><\/p>\n<p><a href=\"http:\/\/www.bhiva.org\/pdf\/2003\/guides\/BHIVA_2003_Guidelines.pdf\">http:\/\/www.bhiva.org\/pdf\/2003\/guides\/BHIVA_2003_Guidelines.pdf<\/a><\/p>\n<p>This is the first major revision for more than two years and contains many significant changes. These include:<\/p>\n<ul>\n<li>Treatment should aim to be initiated while CD4 count is above 200 cells\/mm3 or at higher levels if symptomatic. Exact timing depends on various factors, including short-term risk.<\/li>\n<li>Triple nucleoside combinations previously recommended such as Trizivir (AZT\/3TC\/abacavir) are not now recommended, even for patients with a lower baselines viral load.<\/li>\n<li>d4T is not recommended for first line therapy due to increased association with lipodystrophy.<\/li>\n<li>Unboosted PI regimens are not recommended for first choice due to poorer pharmacokinetics, and less convenient dosing.<\/li>\n<li>The committee believes there is no definitive evidence on which to base a preference for either choice of nucleosides or choice of PI or NNRTI.<\/li>\n<li>Considerations for regimens include ease of adherence and minimising toxicity, and should take account of individual factors such as hepatitis B\/C, risk of cardiovascular disease, diabetes, psychiatric disease, and lifestyle.<\/li>\n<li>Treatment in primary HIV infection is recommended if needed to relieve severe symptoms but is not generally recommended otherwise, unless as part of a clinical trial.<\/li>\n<li>Use of resistance testing is recommended for all treatment na\u00efve patients prior to starting treatment. In practice, this means that people should receive or have a sample stored for later testing when diagnosed.<\/li>\n<li>Therapeutic drug monitoring (TDM) is seen as being of value in specific circumstances, such as reducing toxicity, and adjusting doses in significant hepatic or renal impairment.<\/li>\n<li>Interrupting or stopping treatment may benefit patients who started treatment earlier than currently recommended \u2013 ie with a high pre-treatment CD4 count (specified as \u2018perhaps 300 cells\/mm3\u2019). The importance of careful monitoring is stressed.<\/li>\n<li>New sections include monitoring tests, management of patients who are using treatment combinations not now recommended in the guidelines (such as Trizivir or d4T), and a table on drug costs.<\/li>\n<li>Sections on the management of side effects such as lactic acidosis, metabolic changes and lipodystrophy have been updated and include, for example, a stronger recommendation for New-Fill).<\/li>\n<\/ul>\n<p>The guidelines will also be published as a supplement to the October issue of HIV Medicine.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Simon Collins, HIV i-Base The British HIV Association (BHIVA) has published the 2003 UK treatment guidelines online in both html and pdf file format. http:\/\/www.bhiva.org\/ http:\/\/www.bhiva.org\/pdf\/2003\/guides\/BHIVA_2003_Guidelines.pdf This is the first major revision for more than two years and contains many &hellip;<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[23],"tags":[],"class_list":["post-11916","post","type-post","status-publish","format-standard","hentry","category-guidelines"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/11916","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=11916"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/11916\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=11916"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=11916"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=11916"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}