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Newly Updated HIV Treatment Guidelines For Adults And Adolescents Available On The World Wide Web

the opportunity to save other classes of potent anti-HIV drugs, some with a higher incidence of undesirable side effects, for later use.

However, "The Panel is concerned about the ability of the abacavir+AZT+3TC regimen to adequately suppress HIV replication in individuals with high baseline levels of plasma viral load," says John G. Bartlett, M.D., chief of the division of infectious diseases at the Johns Hopkins University Medical Center and co-chair of the Panel.

In addition, abacavir has been associated with a hypersensitivity syndrome that can be life-threatening. In clinical trials, the hypersensitivity syndrome associated with abacavir occurred in approximately 5 percent of patients. In cases where the drug was discontinued because of hypersensitivity reactions and then re-introduced, life-threatening exacerbations of the hypersensitivity syndrome occurred. A medication guide and warning card providing information about recognizing the abacavir hypersensitivity syndrome should be dispensed with each abacavir prescription.

Currently, the Panel recommends using the abacavir-containing regimen as an "alternative" to the preferred regimens delineated in the Guidelines, which include two nucleoside analog reverse transcriptase inhibitors in combination with either a protease inhibitor or efavirenz, a non-nucleoside reverse transcriptase inhibitor.

The Panel also considered recently published data suggesting that HIV-infected women experience more rapid disease progression compared with men who have the same level of virus in their bloodstream. These data were obtained in studies of women who were injecting drug users, and the results have not been consistently observed in other studies. The Panel therefore did not recommend that women begin antiretroviral therapy earlier than men, but will continue to closely follow developments in this field.

The revised Guidelines also include a hypertext link to a brief discussion of the cont
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Contact: Greg Folkers
gfolkers@nih.gov
301-496-2263
NIH/National Institute of Allergy and Infectious Diseases
5-May-1999


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