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Title: Guidelines for antiretroviral therapy in HIV-1 infected adults and adolescents 2014, Thailand
Authors: Weerawat Manosuthi
Sumet Ongwandee
Sorakij Bhakeecheep
Manoon Leechawengwongs
Kiat Ruxrungtham
Praphan Phanuphak
Narin Hiransuthikul
Winai Ratanasuwan
Ploenchan Chetchotisakd
Woraphot Tantisiriwat
Sasisopin Kiertiburanakul
Anchalee Avihingsanon
Akechittra Sukkul
Thanomsak Anekthananon
Thailand Ministry of Public Health
National Health Security Office
Thai AIDS Society
Chulalongkorn University
The HIV Netherlands Australia Thailand Research Collaboration
Mahidol University
Khon Kaen University
Srinakharinwirot University
Keywords: Biochemistry, Genetics and Molecular Biology;Immunology and Microbiology;Medicine
Issue Date: 24-Apr-2015
Citation: AIDS Research and Therapy. Vol.12, No.1 (2015)
Abstract: © Manosuthi et al.; licensee BioMed Central. New evidence has emerged regarding when to commence antiretroviral therapy (ART), optimal treatment regimens, management of HIV co-infection with opportunistic infections, and management of ART failure. The 2014 guidelines were developed by the collaborations of the Department of Disease Control, Ministry of Public Health (MOPH) and the Thai AIDS Society (TAS). One of the major changes in the guidelines included recommending to initiating ART irrespective of CD4 cell count. However, it is with an emphasis that commencing HAART at CD4 cell count above 500 cell/mm<sup>3</sup> is for public health, in term of preventing HIV transmission and personal benefit. In tuberculosis co-infected patients with CD4 cell counts ≤50 cells/mm<sup>3</sup> or with CD4 cell counts >50 cells/mm<sup>3</sup> who have severe clinical disease, ART should be initiated within 2 weeks of starting tuberculosis treatment. The preferred initial ART regimen in treatment naïve patients is efavirenz combined with tenofovir and emtricitabine or lamivudine. Plasma HIV viral load assessment should be done twice a year until achieving undetectable results; and will then be monitored once a year. CD4 cell count should be monitored every 6 months until CD4 cell count ≥350 cells/mm<sup>3</sup> and with plasma HIV viral load <50 copies/mL; then it should be monitored once a year afterward. HIV drug resistance genotypic test is indicated when plasma HIV viral load >1,000 copies/mL while on ART. Ritonavir-boosted lopinavir or atazanavir in combination with optimized two nucleoside-analogue reverse transcriptase inhibitors is recommended after initial ART regimen failure. Long-term ART-related safety monitoring has also been included in the guidelines.
ISSN: 17426405
Appears in Collections:Scopus 2011-2015

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