The most appropriate antiretroviral therapy (ART) regimen is one based upon assessment of the ease of adherence, tolerability and efficacy according to current guidelines, while accounting for the individual’s
wishes, context, lifestyle, comorbidities and other medications.
While ART is recommended for all people living with HIV, appropriate treatment strategies will vary based on individual needs.1
International guidelines now recommend ART initiation in all HIV-infected persons, regardless of CD4+ cell count, as a means of reducing disease progression and the future spread of HIV.1-3
Therapy should be initiated as soon as possible, however ART may be deferred on a case-by-case basis due to clinical and/or psychosocial factors. 1
Factors to consider when initiating or switching ART
Although the DHHS Guidelines recommend initiation of ART as soon as possible, various individual- and treatment-related factors need to be taken into consideration.1
Patient lifestyle and preference
Baseline viral load and CD4 count
Adverse effect profiles
Comorbidities and coinfections (e.g. hyperlipidemia or osteoporosis)
Hepatic and renal function
Adherence potential, both today and over the course of a lifetime
Baseline resistance (e.g. HIV genotypic drug resistance test results and HLA-B*5701 status)
Potential short- or long-term side effects
Drug–drug interaction potential
The most appropriate ART regimen is one based upon assessment of the ease of adherence, tolerability and efficacy, according to current guidelines, while accounting for the individual’s wishes, context, lifestyle, comorbidities and other medications.
A summary of ART guidelines from the United States Department of Health and Human Services (DHHS).