MONDAY, July 19 (HealthDay News) -- Against a shifting risk-benefit balance for antiretroviral therapy (ART) that supports earlier HIV treatment, an expert panel has issued new recommendations for treating adult HIV infections. These recommendations have been published in the July 21 issue of the Journal of the American Medical Association to coincide with presentation at the International AIDS Conference, held from July 18 to 23 in Vienna, Austria.

Melanie A. Thompson, M.D., of the AIDS Research Consortium of Atlanta, and colleagues on the International AIDS Society-USA panel reviewed data published or presented since the last panel report in 2008. They recommend that, before beginning ART, patients should be willing to adhere to lifelong therapy.

In addition, the panel recommends ART for asymptomatic patients at or below a CD4 cell count of 500/µL, as well as symptomatic patients and those with other issues such as pregnancy, a rapid decline in CD4 count of more than 100/µL per year, or active hepatitis B or C infection. Therapy should also be considered in asymptomatic patients with CD4 counts above 500/µL, they write, and patients on ART should be monitored frequently during the first year to assess the effect of the treatment. The authors also discuss medication options.

"Advances in ART have shown that AIDS, as traditionally defined, can be prevented. One of the greatest challenges is that full implementation of these guidelines will require addressing social and structural barriers to diagnosis and care, as well as the pervasive stigma and discrimination associated with an HIV diagnosis," the authors conclude.

Most of the co-authors disclosed financial relationships with a variety of pharmaceutical and/or medical device companies, and a number of companies have provided grants to the International AIDS Society-USA.

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