Southern African HIV Clinicians Society adult antiretroviral therapy guidelines: Update on when to initiate antiretroviral therapy
The most recent version of the Southern African HIV Clinicians Society’s adult antiretroviral therapy (ART) guidelines was published in December 2014. In the 27 August 2015 edition of the New England Journal of Medicine, two seminal randomised controlled trials that addressed the optimal timing of A...
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doaj-0f780481db714f56ae22e1cefffbf8072020-11-24T23:26:31ZengAOSISSouthern African Journal of HIV Medicine1608-96932078-67512015-12-01161e1e410.4102/sajhivmed.v16i1.428345Southern African HIV Clinicians Society adult antiretroviral therapy guidelines: Update on when to initiate antiretroviral therapyGraeme Meintjes0John Black1Francesca Conradie2Sipho Dlamini3Gary Maartens4Thandekile C. Manzini5Moeketsi Mathe6Michelle Moorhouse7Yunus Moosa8Jennifer Nash9Catherine Orrell10Francois Venter11Douglas Wilson12Department of Medicine and Institute of Infectious Disease and Molecular Medicine, University of Cape TownDepartment of Medicine, Livingstone HospitalRight to Care and Clinical HIV Research Unit, University of WitwatersrandDivision of Infectious Diseases & HIV Medicine, Department of Medicine, University of Cape TownDivision of Clinical Pharmacology, University of Cape TownDepartment of Infectious Diseases, King Edward VIII Hospital, University of KwaZulu-NatalPrivate practice, VereenigingWits Reproductive Health and HIV Institute, JohannesburgDepartment of Infectious Diseases, University of KwaZulu-NatalAmathole District Clinical Specialist Team, Eastern CapeDesmond Tutu HIV Foundation, University of Cape TownWits Reproductive Health and HIV Institute, JohannesburgDepartment of Internal Medicine, Edendale Hospital, University of KwaZulu-NatalThe most recent version of the Southern African HIV Clinicians Society’s adult antiretroviral therapy (ART) guidelines was published in December 2014. In the 27 August 2015 edition of the New England Journal of Medicine, two seminal randomised controlled trials that addressed the optimal timing of ART in HIV-infected patients with high CD4 counts were published: Strategic timing of antiretroviral therapy (START) and TEMPRANO ANRS 12136 (Early antiretroviral treatment and/or early isoniazid prophylaxis against tuberculosis in HIV-infected adults). The findings of these two trials were consistent: there was significant individual clinical benefit from starting ART immediately in patients with CD4 counts higher than 500 cells/μL rather than deferring until a certain lower CD4 threshold or clinical indication was met. The findings add to prior evidence showing that ART reduces the risk of onward HIV transmission. Therefore, early ART initiation has the public health benefits of potentially reducing both HIV incidence and morbidity. Given this new and important evidence, the Society took the decision to provide a specific update on the section of the adult ART guidelines relating to when ART should be initiated.https://sajhivmed.org.za/index.php/hivmed/article/view/428 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Graeme Meintjes John Black Francesca Conradie Sipho Dlamini Gary Maartens Thandekile C. Manzini Moeketsi Mathe Michelle Moorhouse Yunus Moosa Jennifer Nash Catherine Orrell Francois Venter Douglas Wilson |
spellingShingle |
Graeme Meintjes John Black Francesca Conradie Sipho Dlamini Gary Maartens Thandekile C. Manzini Moeketsi Mathe Michelle Moorhouse Yunus Moosa Jennifer Nash Catherine Orrell Francois Venter Douglas Wilson Southern African HIV Clinicians Society adult antiretroviral therapy guidelines: Update on when to initiate antiretroviral therapy Southern African Journal of HIV Medicine |
author_facet |
Graeme Meintjes John Black Francesca Conradie Sipho Dlamini Gary Maartens Thandekile C. Manzini Moeketsi Mathe Michelle Moorhouse Yunus Moosa Jennifer Nash Catherine Orrell Francois Venter Douglas Wilson |
author_sort |
Graeme Meintjes |
title |
Southern African HIV Clinicians Society adult antiretroviral therapy guidelines: Update on when to initiate antiretroviral therapy |
title_short |
Southern African HIV Clinicians Society adult antiretroviral therapy guidelines: Update on when to initiate antiretroviral therapy |
title_full |
Southern African HIV Clinicians Society adult antiretroviral therapy guidelines: Update on when to initiate antiretroviral therapy |
title_fullStr |
Southern African HIV Clinicians Society adult antiretroviral therapy guidelines: Update on when to initiate antiretroviral therapy |
title_full_unstemmed |
Southern African HIV Clinicians Society adult antiretroviral therapy guidelines: Update on when to initiate antiretroviral therapy |
title_sort |
southern african hiv clinicians society adult antiretroviral therapy guidelines: update on when to initiate antiretroviral therapy |
publisher |
AOSIS |
series |
Southern African Journal of HIV Medicine |
issn |
1608-9693 2078-6751 |
publishDate |
2015-12-01 |
description |
The most recent version of the Southern African HIV Clinicians Society’s adult antiretroviral therapy (ART) guidelines was published in December 2014. In the 27 August 2015 edition of the New England Journal of Medicine, two seminal randomised controlled trials that addressed the optimal timing of ART in HIV-infected patients with high CD4 counts were published: Strategic timing of antiretroviral therapy (START) and TEMPRANO ANRS 12136 (Early antiretroviral treatment and/or early isoniazid prophylaxis against tuberculosis in HIV-infected adults). The findings of these two trials were consistent: there was significant individual clinical benefit from starting ART immediately in patients with CD4 counts higher than 500 cells/μL rather than deferring until a certain lower CD4 threshold or clinical indication was met. The findings add to prior evidence showing that ART reduces the risk of onward HIV transmission. Therefore, early ART initiation has the public health benefits of potentially reducing both HIV incidence and morbidity. Given this new and important evidence, the Society took the decision to provide a specific update on the section of the adult ART guidelines relating to when ART should be initiated. |
url |
https://sajhivmed.org.za/index.php/hivmed/article/view/428 |
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