Walsh & Hoyt: Therepeutic Recommendations

Therapeutic guidelines for treatment of HIV infections depend on the presence of symptoms, viral load, CD4+ T-cell counts, and other special circumstances. The general consensus is that all patients with symptomatic HIV disease should be given antiretroviral therapy. In asymptomatic, HIV-infected individuals, therapy should be used in the event of a high viral titer or declining CD4 T-cell count (fewer than 200 cells/mm3). In the setting of an intermediate CD4+ T-cell count; i.e., between 200 and 350 cells/mm3, the decision to initiate therapy should be made in consultation with the patient but should be strongly considered if the viral load is increasing, the cell count is decreasing, or both.