The commentary on the US Department of Health and Human Services (DHHS) 'Guidelines for the use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents' is updated each year by a sub-committee of the Australasian Society for HIV Medicine (ASHM).
As in previous years the Australian commentary provides advice to Australian health professionals on important local issues relevant to the treatment of people with HIV in Australia. The new website will improve access to the commentary.
The commentary encourages an approach in which people with HIV work closely with their doctors and consider their own individual circumstances when making decisions about treatment. They are encouraged to weigh the evidence and consider the potential benefits and risks of treatment, including HIV prevention benefits.
Key points from the commentary related to starting treatment are:
- For individuals with a CD4 count below 350, starting treatment is strongly recommended
- For those with a CD4 count between 350 and 500 treatment is recommended following discussion of the limitations of the current knowledge of benefits and risks
- For people with a CD4 count above 500, the recommendation is that there is limited evidence but treatment should be considered in specific circumstances, including early HIV infection, hepatitis B or tuberculosis co-infection, or HIV associated neurocognitive disorders.
The ASHM Sub-committee for Guidance on HIV Management in Australia, which updated the commentary, notes that these general recommendations need to be individualised.
