Scott Hammer a Columbia University researcher and a member of the International AIDS Society-USA Panel indicated that new data he had analyzed in the field over the last two years suggests initiating therapy before CD4 cell count declines to less than 350/L.
According to Hammer, a number of factors should be considered to decide whether to initiate therapy, including: patients with 350 CD4 cells/L or more, patient readiness, drug interactions, adherence challenges, toxicities and cost.
Hammer suggested new guidelines recommending certain drugs such as Sustiva (efavirenz) be given high consideration. He addressed changing therapies and when to introduce new drugs.
Genotypic testing for drug resistance should be performed for certain patients. Appropriate assessment of other conditions and monitoring for toxicity should be performed before initiating treatment and during follow-up, the authors write in the Aug. 6 issue of the Journal of the American Medical Association.
The guidelines were published on Sunday at the start of a six-day International AIDS Conference in Mexico City in which more than 20,000 scientists, policymakers and grassroots workers are participating.
