BACKGROUND: Individuals with advanced HIV infection naïve to antiretroviral therapy represent a special population of patients frequently encountered in clinical practice. They are at high risk of disease progression and death, and their viroimmunologic response following the initiation of highly active antiretroviral therapy may be more incomplete or slower than that of other patients. Infection management in such patients can also be complicated by underlying conditions, comorbidities, and the need for concomitant medications. AIM: To provide practical guidelines to those clinicians providing care to HIV-infected patients in terms of diagnostic assessment, monitoring, and treatment. CONCLUSIONS: The principals of antiretroviral treatment in asymptomatic naïve patients with advanced HIV infection are the same as those applicable to the general population with asymptomatic HIV infection. Naïve patients with advanced HIV infection and a history of AIDS-defining illnesses urgently need antiretroviral treatment, with the choice of antiretroviral regimen and timetable based on such factors as concomitant treatment and prophylaxis, drug interactions, and potential concomitant drug toxicity. Finally, an adequate counseling program - both before and after HIV-testing - that includes aspects other than treatment adherence monitoring is a crucial step in disease management.
|Titolo:||Italian consensus statement on management of HIV-infected individuals with advanced disease naive to antiretroviral therapy|
|Parole Chiave:||HEPATITIS-C VIRUS ; PNEUMOCYSTIS-CARINII-PNEUMONIA ; AIDS-RELATED MALIGNANCIES ; LONG-TERM SAFETY ; CD4 CELL COUNTS ; SECONDARY PROPHYLAXIS ; NAIVE PATIENTS ; CYTOMEGALOVIRUS RETINITIS ; INITIAL RESPONSE ; CONTROLLED-TRIAL|
|Settore Scientifico Disciplinare:||Settore MED/04 - Patologia Generale|
|Data di pubblicazione:||lug-2009|
|Digital Object Identifier (DOI):||10.1007/s15010-008-8134|
|Appare nelle tipologie:||01 - Articolo su periodico|