Abstract
OBJECTIVE
To update recommendations for antiretroviral therapy for adult human
immunodeficiency virus type 1 (HIV-1) infection, based on new information
and drugs that are available.
PARTICIPANTS
A 17-member international physician panel with antiretroviral research
and HIV patient care experience initially convened by the International AIDS
Society–USA in December 1995.
EVIDENCE
Available clinical and basic science data including phase 3 controlled
trials; data on clinical, virologic, and immunologic end points; research
conference reports; HIV pathogenesis data; and panel expert opinion. Recommendations
were limited to therapies available (US Food and Drug Administration approved)
in 1999.
CONSENSUS PROCESS
The panel assesses new research reports and interim results and regularly
meets to consider how the new data affect therapy recommendations. Recommendations
are updated via full-panel consensus. Guidelines are presented as recommendations
if the supporting evidence warrants routine use in the particular situation
and as considerations if data are preliminary or incomplete but suggestive.
CONCLUSIONS
The availability of new antiretroviral drugs has expanded treatment
choices. The importance of adherence, emerging long-term complications of
therapy, recognition and management of antiretroviral failure, and new monitoring
tools are addressed. Optimal care requires individualized management and ongoing
attention to relevant scientific and clinical information in the field.
