New Guidelines for When to Start Antiretroviral Therapy - An
Optimistic View As we approach the 20th anniversary of the
original description of the clinical syndrome now known as AIDS,
treatment paradigms (patterns) continue to evolve and the
pendulum still swings. Nowhere is this more evident than in the
guidelines for when to start antiretroviral therapy for HIV. In
fact, the only constant regarding the recommendations for
initiating treatment is that they keep changing. In February
2001, the Department of Health and Human Services Panel on
Clinical Practices for Treatment of HIV Infection, to much
fanfare, changed these recommendations once again. In this
article, I will summarize the new guidelines, place them into
historical perspective, and then clarify what the modifications
mean in clinical practice. Details of the most recent guidelines
for the use of antiretroviral agents in HIV-infected adults and
adolescents can be found at www.hivatis.org. The recommendations
for starting antiretroviral therapy h