Clinical posts from members and guests of the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) from various international medical and scientific conferences on HIV, AIDS, viral hepatitis, and sexual health.
Treatment in Primary HIV Infection
The new EACS guidelines give recommendation for treatment of asymptomatic primary HIV infection (PHI) even when CD4 count is >350. There is strong recommendation to treat if severe or prolonged symptoms, neurological disease, Age>50yrs and if CD4 <350. A French study (ANRS PRIMO cohort) showed rapid viral suppression in 327 patients treated within 1 month of diagnosis of primary infection (91.4% were symptomatic). Median CD4 count was 450. There were 2 cases of remission when treatment was interrupted in the ANRS OPTIPRIM study. The EACS guideline has recommended a regime including PI/r if resistance testing results are not available. Evidence is mostly derived from symptomatic patients and evidence on long term clinical benefits is lacking. The rapid suppression of viral load by Integrate inhibitors was discussed but has not been included in the guideline.