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The U.S. Department of Health and Human Services has issued a new set of HIV treatment guidelines for adults and adolescents, replacing those issued in December 2009. For clinicians, the most important changes are probably the slight alterations to the recommendations for routine monitoring. The guidelines now suggest that in stable patients with robust CD4-cell counts, the frequency of CD4 monitoring can be reduced to every 6 to 12 months. Meanwhile, “virologic failure” is now defined as confirmed viremia >200 copies/mL, rather than as any detectable viremia — a change that should alleviate much of the unnecessary panic caused by assay variability or viral “blips.”
Other changes include the following:
Clinicians are reminded that standard ge…