HealthDay News — Recommendations for the use of antiretroviral therapy in HIV infection have been updated for adults, and published in the July 12 issue of the Journal of the American Medical Association, a theme issue on HIV/AIDS.

Huldrych F. Günthard, MD, from the University Hospital Zurich, and colleagues updated recommendations for the use of antiretroviral therapy in adults with established HIV infection. A panel of experts in HIV research and patient care reviewed data and conducted comprehensive literature searches to develop recommendations.

The researchers note that newer data support the widely accepted recommendation that all individuals with HIV infection with detectable viremia should start antiretroviral therapy, regardless of CD4 cell count. For most patients, recommended optimal initial regimens are two nucleoside reverse transcriptase inhibitors (NRTIs) plus an integrase strand transfer inhibitor. Non-NRTIs or boosted protease inhibitors with two NRTIs are also effective regimens. Convenience, tolerability, simplification, anticipation of potential new drug interactions, and pregnancy or plans for pregnancy are included as reasons for switching therapy. In persons at high risk, daily tenofovir disoproxil fumarate/emtricitabine is recommended for use as preexposure prophylaxis to prevent HIV infection; postexposure prophylaxis should be started as soon as possible after exposure, when indicated.

“Antiretroviral agents remain the cornerstone of HIV treatment and prevention,” the authors write. “With these treatment regimens, survival rates among HIV-infected adults who are retained in care can approach those of uninfected adults.”

Several authors disclosed financial ties to the pharmaceutical industry.

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