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Treatment Guidelines 2005

A Pocket Guide to Adult HIV/AIDS Treatment January 2005 edition

When to Start Therapy
Clinical CategoryCD4+ CountViral LoadRecommendation
Symptomatic (AIDS or
severe symptoms)
Any valueAny valueTreat
Asymptomatic, AIDSCD4+ < 200/mm3Any valueTreat
AsymptomaticCD4+ > 200/mm3
but < 350/mm3
Any valueOffer treatment, but controversial †
AsymptomaticCD4+ > 350/mm3> 100,000 c/mLConsider therapy or observe † (Data inconclusive for either alternative)
AsymptomaticCD4+ > 350/mm3< 100,000 c/mlDefer therapy and
observe

* There are special considerations for pregnant women; consult Pregnancy Tables 1-3.

† Patient readiness, probability of adherence, and prognosis based on CD4 count and HIV load need to be considered.


The U.S. Department of Health and Human Services (DHHS) issues guidelines to help doctors treat people with HIV in the United States. Treatment of Asymptomatic HIV infection when CD4+ > 200/mm3 is now described as controversial.

Current recommendation is that antiretroviral drugs are for people diagnosed with AIDS - either by low CD4 or one of the AIDS defining conditions.

We need to edit the article to either remove statements that are controversial or say that they are now controversial

Sci guy 02:48, 13 Jun 2005 (UTC)

HIV and Its Treatment: What You Should Know - May, 2005

I am quoting these two sections in full, so that I cannot be accused of selective editing. They clarify two issues. First that current treatment guidelines do not recommend treatment of asymptomatic HIV infection when viral load is less than 100,000 copies/mL and CD4 count is above 350 cells/mm3. Secondly they explain the reason for deferring treatment in these persons in simple terms. Sci guy 14:39, 17 Jun 2005 (UTC)

How will I know when to start anti-HIV medications?

You and your doctor should consider three factors in deciding when to start treatment: 1) symptoms of advanced HIV disease, 2) viral load, and 3) CD4 count.

You should start treatment if:

  • you are experiencing severe symptoms of HIV infection or have been diagnosed with AIDS
  • your viral load is 100,000 copies/mL or more
  • your CD4 count is 200 cells/mm3 or less

You may also consider starting treatment if your CD4 count is between 200 and 350 cells/mm3; this is something you should discuss with your doctor.

If the anti-HIV medications can help me stay healthy, why wait to start treatment?

Once you begin treatment, you may need to continue taking anti-HIV medications for the rest of your life. Although newer anti-HIV medications are easier to take, starting treatment usually means a significant adjustment in your lifestyle. Some anti-HIV medications need to be taken several times a day at specific times and may require a change in meals and mealtimes.

In addition to their desired effects, anti-HIV medications may have negative side effects, some of which are serious. If the virus is not suppressed completely, drug resistance can develop. Side effects and drug resistance may limit your future treatment choices.

source:HIV and Its Treatment: What You Should Know - May, 2005

Antiretroviral Postexposure Prophylaxis

January 21, 2005 CDC recommended that people exposed to the AIDS virus from rapes, accidents or occasional unsafe sex or drug use be given potentially lifesaving medications that can keep them from becoming infected. This treatment should start no more than 72 hours after a person has been exposed to the virus, and the drugs should be used by patients for 28 days. This emergency drug treatment has been recommended since 1996 for health-care workers accidentally stuck with a needle, splashed in the eye with blood, or exposed in some other way on the job. [1] Sci guy 15:01, 17 Jun 2005 (UTC)