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Current Concepts in the Treatment of HIV Infection with Focus on Brain Disease 

Current Concepts in the Treatment of HIV Infection with Focus on Brain Disease
Chapter:
Current Concepts in the Treatment of HIV Infection with Focus on Brain Disease
Author(s):

Susan Swindells

and Uriel Sandkovsky

DOI:
10.1093/med/9780195399349.003.0067
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date: 17 June 2019

In recent years, guidelines for initiating antiretroviral therapy (ART) have evolved with a trend towards starting therapy at earlier stages of disease. ART is now recommended for all patients with CD4 counts of less than 350 cells/mm3. These guideline changes have been driven by the development of drug regimens that are simpler, more tolerable, and possessing of improved resistance profiles. HIV viremia of >100,000 copies/mL and a decline of more than 100 CD4 cells/ mm3 in one year are also considered when deciding to start therapy earlier. Patients with hepatitis B and C co-infections, those at high risk of cardiovascular disease, and/or those having HIV-associated nephropathy may also benefit from early initiation of therapy. Specialist expertise is recommended to assess the potential risks and benefits of specific decisions about the management of HIV diseases, preferably provided in the context of a multidisciplinary team.

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