When to start ART in the setting of acute AIDS-related opportunistic infections: the time is now!

Abstract

Despite the substantial benefits of combination antiretroviral therapy (ART), a significant proportion of HIV-infected individuals still present with advanced disease and active AIDS-related opportunistic infections (OIs). The weight of evidence from recent studies supports the early initiation of ART (ie, within 2 weeks of initiating treatment for the acute OIs). Initiating ART early in acutely ill patients can reduce AIDS-related progression and death. Early ART has not been associated with increased rates of immune reconstitution inflammatory syndrome in prospective studies of non-tuberculosis OIs, although this concern is frequently cited as a reason to delay ART. Nor has early ART been associated with increased adverse outcomes. Nonetheless, initiating ART early in acute care settings can be challenging to implement and requires a well-coordinated multidisciplinary team with expertise in ART management.

• Authors: Philip M Grant, Andrew R Zolopa
• Journal: Current HIV/AIDS reports (Curr HIV/AIDS Rep) Vol. 9 Issue 3 Pg. 251-8 (Sep 2012) ISSN: 1548-3576 [Electronic] United States
• PMID: 22733609 (Publication Type: Journal Article, Review)

Chemical References

• Anti-HIV Agents

Topics

• AIDS-Related Opportunistic Infections (drug therapy, immunology)
• Acquired Immunodeficiency Syndrome (complications, drug therapy, immunology)
• Acute Disease
• Anti-HIV Agents (administration & dosage)
• Drug Administration Schedule
• Female
• Humans
• Male
• Meningitis, Cryptococcal (drug therapy, immunology)
• Pneumocystis Infections (drug therapy, immunology)
• Pneumocystis carinii (immunology)
• Time Factors