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New guidelines on treating those with HIV developed

By Meredith Cohn, The Baltimore Sun –

Some leading AIDS experts have issued the first guidelines aimed exclusively at getting those newly diagnosed with HIV into treatment and keeping them in it.

Thirty one international experts, including three Johns Hopkins faculty members, used 325 studies involving tens of thousands of people infected with HIV to develop the guidelines for the International Association of Physician in AIDS Care.

HIV, which infects about 50,000 Americans a year, is now treatable. More than a million people are believed to be living with HIV. But that doesn’t mean everyone is getting the care they need — about two-thirds have never use the most effective antiretroviral drug therapy, only 59 percent continue the therapy and less than a third have suppressed or nearly suppressed their disease.

“Clearly, there is lots of room for improvement in how we, as care providers, can get new patients into treatment and help them adhere to the often strict drug regimens needed to suppress the viral disease and prevent drug resistance,” Dr. Larry W. Chang, a guidelines co-author and an assistant professor at Johns Hopkins, said in a statement.

The guidelines were published online in the Annals of Internal Medicine. And Chang, an infectious-disease specialist, said they were important to save the lives of HIV patients. He said those who miss their follow-up care within the first year of receiving treatment tend to die at twice the rate of those who stay with the regimen.

Those who suppress their virus are much less likely to give it to others, making the guidelines an important prevention tool as well, say the researchers.

Strategies may involve helping the newly diagnosed navigate services available and finding aid for them, having someone call to follow-up about medications or developing an automated system to alert pharmacists or physicians when prescriptions aren’t filled. Reducing the number of pills needed would also be beneficial, as would one-on-one counseling, the guidelines say.

The group plans more research and an accredited, online medical education program for health care providers.

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