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Know Your Patient: What Conditions Affect Initial HIV Treatment Success?University of Medicine and Dentistry of New Jersey, Infectious Disease, Newark, hoddersa{at}umdnj.edu Highly active antiretroviral therapy has substantially improved the outlook for persons with HIV, and the combination of clinical trial data and experience has provided guidance for the best use of highly active antiretroviral therapy to balance efficacy, safety, tolerability, and adherence. The nonnucleoside reverse transcriptase inhibitors (NNRTIs) and several of the boosted protease inhibitors (PIs, eg, lopinavir/ritonavir) have shown high levels of viral suppression and CD4 count increases as initial therapy. Preliminary evidence suggests that NNRTI regimens may be more forgiving of certain levels of nonadherence than PIs. The evidence also shows that not all agents or combinations of agents are appropriate for all HIV patients. Patient factors such as lipids and triglycerides, hyperglycemia/diabetes, renal function, weight, gender, probability of and desire for pregnancy, initial CD4 count, race, and mental health status will all need to be considered to select the best therapy for the individual.
Key Words: HIV • HAART • side effects • clinical trials
This version was published on March
1, 2008 Journal of the International Association of Physicians in AIDS Care (JIAPAC), Vol. 7, No. 1 suppl,
S5-S9 (2008) |
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