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Southern African HIV Clinicians Society adult antiretroviral therapy guidelines: Update on when to initiate antiretroviral therapy

机译：南部非洲HIV临床医师协会成人抗逆转录病毒治疗指南：何时开始抗逆转录病毒治疗的最新信息

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The most recent version of the Southern African HIV Clinicians Society’s adult antiretroviral therapy (ART) guidelines was published in December 2014. In the 27 August 2015 edition of the New England Journal of Medicine, two seminal randomized controlled trials that addressed the optimal timing of ART in HIV-infected patients with high CD4 counts were published: Strategic timing of antiretroviral therapy (START) and TEMPRANO ANRS 12136 (Early antiretroviral treatment and/or early isoniazid prophylaxis against tuberculosis in HIV-infected adults). The findings of these two trials were consistent: there was significant individual clinical benefit from starting ART immediately in patients with CD4 counts higher than 500 cells/μL rather than deferring until a certain lower CD4 threshold or clinical indication was met. The findings add to prior evidence showing that ART reduces the risk of onward HIV transmission. Therefore, early ART initiation has the public health benefits of potentially reducing both HIV incidence and morbidity. Given this new and important evidence, the Society took the decision to provide a specific update on the section of the adult ART guidelines relating to when ART should be initiated.
机译：南部非洲HIV临床医生协会的成人抗逆转录病毒疗法（ART）指南的最新版本于2014年12月发布。在2015年8月27日的《新英格兰医学杂志》中，两项具有开创性的随机对照试验探讨了ART的最佳时机发表了有关CD4计数高的HIV感染患者的研究报告：抗逆转录病毒疗法（START）和TEMPRANO ANRS 12136（对受HIV感染的成年人进行早期抗逆转录病毒治疗和/或早期异烟肼预防结核病的策略性时机）。两项试验的结果是一致的：CD4计数高于500细胞/μL的患者立即开始抗逆转录病毒疗法具有显着的个人临床获益，而不是推迟到达到某个较低的CD4阈值或达到临床适应症为止。这些发现增加了先前的证据，表明抗逆转录病毒疗法降低了艾滋病毒继续传播的风险。因此，尽早开展抗逆转录病毒疗法具有潜在的公共卫生益处，可以潜在地减少艾滋病毒的发病率和发病率。有了这些新的重要证据，协会决定对成人抗逆转录病毒治疗指南中有关何时应开始抗病毒治疗的部分进行具体更新。

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