AIDS care panel issues new HIV guidelines

The International Association of Physicians in AIDS Care (IAPAC) has issued new guidelines on improving adherence to antiretroviral therapy (ART).

To help clinicians monitor and support adherence to ART in HIV-infected patients, IAPAC convened a panel of experts who conducted a systematic review of 325 randomized, controlled trials and observational studies. Members of the panel drafted recommendations and then graded the overall quality of evidence for and strength of each.

The panel made a total of 37 recommendations in the following categories:

• entry into and retention in HIV medical care,
• monitoring ART adherence,
• interventions to improve ART adherence,
• adherence tools for patients,
• education and counseling interventions,
• health system and service delivery interventions and
• special populations (including pregnant women, patients with substance use or mental health disorders, incarcerated or homeless patients, and children and adolescents).

The panel also called for further cost-effectiveness research on ART as well as research in areas where evidence was insufficient to make recommendations, such as in patients with HIV infection and one or more comorbid conditions.

The full recommendations were published early online March 6 by Annals of Internal Medicine.