Guidelines for the Clinical Management and Treatment of HIV Infected Adults in Europe 2008EACS2008

HIV Medicine (Impact Factor: 3.99). 01/2008; 9(2):65 - 71. DOI: 10.1111/j.1468-1293.2007.00533.x


A working group of the European AIDS Clinical Society (EACS) have developed these guidelines for European clinicians to help them in the treatment of adults with HIV infection. This third version of the guidelines includes, as new topics, the assessment of patients at initial and subsequent clinic visits as well as post-exposure prophylaxis. A revision of the 2005 guidelines based on current data includes changes in the sections on primary HIV infection, when to initiate therapy, which drug combinations are preferred as initial combination regimens for antiretroviral-naïve patients, how to manage virological failure and the treatment of HIV during pregnancy.
In Europe, there is a wide range of clinical practices in antiretroviral therapy depending on various factors such as drug registration, national policies, local availability, reimbursement and access to treatment. These can vary greatly from one country to another, especially in Central and Eastern parts of Europe.
These guidelines are intended to help clinicians achieve the best care for their patients. In some countries, particularly where the quality of and access to care are not optimal, these guidelines should help AIDS societies and physicians or patient group organizations to negotiate with their national health authorities with a view to implementing what should be the standard of care for HIV-infected patients all over Europe.

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Available from: Anton L Pozniak, Oct 13, 2014
    • "In addition, 803 GRTs (46.4%) were from cART-naı¨ve patients. Most of the resistance tests were performed after 2008, when GRTs were strongly recommended also in ARTnaı¨ve patients [14]. "

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    • "All participants were male, treatment naïve, and asymptomatic HIV-infected patients as determined by the presence of antibodies against HIV measured by enzyme-linked immunosorbent assay (ELISA) and confirmed by Western blot. All patients were at CDC A2 clinical stage and fulfilled the criteria for ART initiation according to the European [36] and International guidelines [37]. The patients were assigned in 2 groups at the discretion of the clinicians. "
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    ABSTRACT: Background Persistent immune activation and inflammation are lying behind HIV-infection even in the setting of ART mediated viral suppression. The purpose of this study is to define the in vivo effect of two first-line ART regimens on certain inflammatory mediators in male HIV patients. Methods Male, naive, HIV-infected volunteers were assigned either to tenofovir-DF/emtricitabine/efavirenz (Group_T) or abacavir/lamivudine/efavirenz (Group_A). Platelet Activating Factor (PAF) levels and metabolic enzymes together with HIV-implicated cytokines (IL-1beta, IL-6, IL-8, IL-10, IL-12p70, TNFa) and VEGF were determined for a 12-month period. Differences within each group were determined by non-parametric Friedman and Wilcoxon test, while the differences between the groups were checked by ANOVA repeated measures. Results Both ART regimens present pronounced effect on inflammatory mediators, resulting in decreased PAF levels and Lipoprotein-associated phospholipase A2 (Lp-PLA2) activity for tenofovir-containing regimen and same as baseline PAF levels with a peak though at the 3rd month as well as elevated Lp-PLA2 activity for abacavir-containing regimen. Conclusions Studies regarding the effect of first-line ART regimens on inflammation may be beneficial in preventing chronic morbidities during HIV-treatment. From this point of view, the present study suggests an anti-inflammatory effect of tenofovir-containing ART, while the temporary increase of PAF levels in abacavir-containing ART may be the link between the reported cardiovascular risk and abacavir administration.
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    • "The primary goal of HIV therapy is to increase disease-free survival and improve health-related quality of life (HRQL) by containing viral replication, avoiding drug resistance, and boosting immunologic function by restoring CD4 count [1,2]. The United States Department of Health and Human Services (DHHS) has recommended several preferred and alternative initial highly active antiretroviral therapy (HAART) regimens which have comparable efficacy, but different pharmacokinetic or pharmacodynamic properties. "
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