AIDS InfoNet www.aidsinfonet.org
Fact Sheet Number 404
U.S. ANTIRETROVIRAL THERAPY GUIDELINES
WHY DO THE GUIDELINES KEEP
We keep learning more about the best way to
fight HIV. In 1998, the US Department of
Health and Human Services created a panel of
physicians, researchers, and consumers to
develop treatment guidelines. They constantly
review AIDS research results. The guidelines
are updated about once each year. The panel
released the latest guidelines in January 2008.
NOTE: These are guidelines, not rules.
Patients should receive individualized care
from a health care provider with experience
treating HIV infection. The full text of these
guidelines is available on the Internet at
VIRAL LOAD AND CD4 CELL
Viral load and CD4 cell tests provide critical
information for decisions on antiretroviral
therapy (ART). Before changing treatment, the
tests should be repeated to confirm the results.
Fact Sheet 124 has more information on CD4
cell tests and Fact Sheet 125 covers viral load
Viral load should be tested:
• Before starting or changing medications.
This provides a reference value;
• About 2 to 8 weeks after starting or
changing medications. This shows whether
the new drugs are working;
• Every 3 or 4 months. This helps make sure
the medications are still working. For
patients who haven’t
medications, it helps decide when to start.
CD4 cell counts should be done:
• When someone first tests HIV-positive
• Every 3 to 6 months to monitor the strength
of the immune system
Viral resistance testing helps health care
providers choose the most effective drugs.
See Fact Sheet 126 for more information.
patients starting therapy, when viral load is not
controlled by new medications, or when it
“breaks through” a regimen that used to work.