SUPPLEMENT |
Chelsea & Westminster Hospital, London, UK
Correspondence to: Dr L Waters, St Stephen's Centre, Chelsea and Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK Email: laura.waters{at}chelwest.nhs.uk
Although several antiretroviral agents are available, realistic options for initial therapy remain limited, as many are not licensed for treatment-naïve patients, as reflected in national and international guidelines. A variety of factors influence treatment choice. From the physicians' perspective, it is important to consider age, sex, co-morbid conditions, concomitant drugs and potential for adherence. Meanwhile, patients are concerned about the impact of side-effects on their day-to-day life and long-term future, drug efficacy, future options and time available in clinics. Patients' concerns may be alleviated by detailed discussion throughout treatment, including the importance of adherence, the pros and cons of different treatments and potential side-effects. Positive outcomes in terms of not just viral load and CD4 counts but also improved duration and quality of life should be emphasized. Treatment must be tailored to each patient to maximize benefits and minimize risks.
Key Words: adherence • antiretroviral • HIV • initial therapy • side-effects • treatment switch • treatment naïve
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