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Issue No. 6  | February 12, 2013
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HHS Adult and Adolescent Antiretroviral Treatment Guidelines Updated

The HHS Panel on Antiretroviral Guidelines for Adults and Adolescents announces the release of the updated Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents.
Key additions and revisions to the guidelines include:

  • Updated recommendation on integrase strand transfer inhibitor (INSTI) resistance testing in individuals failing an INSTI-based regimen
  • Guidance on use of a newly available genotypic tropism assay to predict HIV-1 coreceptor usage
  • Updated recommendations on initiation of antiretroviral therapy (ART) in treatment-naive individuals
  • Updates to What to Start, including guidance on use of rilpivirine (RPV)-based regimens and elvitegravir/cobicistat/tenofovir/emtricitabine (EVG/COBI/TDF/FTC) in ART-naive individuals
  • Strengthening of recommendation for initiation of ART in individuals with acute/recent (early) HIV infection from “should be considered optional (CIII)” to “should be offered (BII)”
  • Updated recommendations on the use of efavirenz (EFV) during pregnancy and IV zidovudine (ZDV) during labor to mirror recent changes in the Perinatal Guidelines
  • New information describing the use of ritonavir (RTV) and COBI as pharmacokinetic enhancers in the drug interaction section
  • Updates to the drug interaction tables, including the addition of known and predicted interactions involving EVG/COBI and other drugs

For a complete preview of key updates to the guidelines, please see What’s New in the Guidelines?
To view or download the guidelines, go to the Adult and Adolescent ARV Guidelines section of AIDSinfo.

Your Feedback Is Welcome

The HHS Panel on Antiretroviral Guidelines for Adults and Adolescents welcomes feedback on the latest revisions to the Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents. Please send your comments with the subject line “Comments on Adult and Adolescent ARV Guidelines” to by February 26, 2013.

FDA Updates Atazanavir Sulfate Capsule Labeling

“Recently [February 4, 2013] FDA approved changes to the Reyataz (atazanavir sulfate) capsule labeling to include the following changes.

“Section 5 Warnings and Precautions was revised to include cholelithiasis ...
“In section 6 Adverse Reactions: Postmarketing Experience, interstitial nephritis was added.

“In section 7 Drug Interactions: information regarding coadministration with boceprevir, carbamazepine, phenytoin, phenobarbital, lamotrigine and voriconazole was added.”

The updated labeling will be available at the FDA website.

More information is available:

NIH Study Suggests Immune System Protein in Semen Boosts HIV Spread in Female Genital Tissue

“An immune system protein normally found in semen appears to enhance the spread of HIV to tissue from the uterine cervix, according to researchers at the National Institutes of Health.

“The protein interleukin 7 (IL-7) belongs to a family of proteins that regulate the immune response. IL-7 is present in normal semen, and occurs at especially high levels in the semen of men with HIV.

“The researchers developed a culture system of small pieces of tissue from the cervix and used this system to simulate male-to-female transmission of HIV, which causes AIDS. They observed the spread of the virus in cervical tissue under controlled laboratory conditions. In the presence of IL-7 at levels typically found in semen of men with HIV, the virus spreads to the tissue more readily than it spreads to tissue not treated with IL-7."

More information is available:

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ISSN 1558-3228