Guidelines for the Use of Antiretroviral Agents in HIV-Infected Adults and Adolescents
CONCLUSION
The Panel has attempted to use the advances in current understanding of the pathogenesis of HIV in the infected person to translate scientific principles and data obtained from clinical experience into recommendations that can be used by the clinician and patient to make therapeutic decisions. The recommendations are offered in the context of an ongoing dialogue between the patient and the clinician after having defined specific therapeutic goals with an acknowledgment of uncertainties. It is necessary for the patient to receive a continuum of medical care and services, including social, psychosocial, and nutritional services, with the availability of expert referral and consultation. To achieve the maximal flexibility in tailoring therapy to each patient over the duration of his or her infection, it is imperative that drug formularies allow for all FDA-approved NRTI, NNRTI, and PI as treatment options. The Panel strongly urges industry and the public and private sectors to conduct further studies to allow refinement of these guidelines. Specifically, studies are needed to optimize recommendations for first-line therapy; to define second-line therapy; and to more clearly delineate the reason(s) for treatment failure. The Panel remains committed to revising their recommendations as such new data become available.
Acknowledgment
The Panel extends special appreciation to Charles Carpenter (Brown
University School of Medicine, Providence, RI) for his advice in the development
of this document and to Gerry Bally (Health Canada) and Anita Rachlis (Sunnybrook
Health Science Centre, University of Toronto, Toronto, Canada) for their
participation. The Panel acknowledges the special contributions of Sharilyn
Stanley, Barbara Brady, and Elaine Daniels in the preparation of this document.
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