Authors' objectives:

This report addresses the following questions:

1. What is the best choice of treatment for HIV?

2. Should treatment be started early or late in HIV infection?

3. What is best treatment for cytomegalovirus retinitis?

4. What is the best prophylactic treatment for pneumocystis carinii?

5. What is the best treatment in special situations eg a) maternal transmission b) needlestick injuries

6. What are the likely costs?

Authors' recommendations: 1. Combination therapy is better than monotherapy; there are good arguments for starting treatment with triple therapy. 2. There appears to be no benefit in early treatment (i.e. when CD4 counts are still above 500cells/mm3). 3. It is not possible to give a simple best choice of combination treatment. It has to be decided for individual patients, taking into account factors such as previous treatment. 4. The best prophylactic treatment for pneumocystis carinii is co-trimoxazole. 5. Maternal transmission is reduced by AZT. Trials of combination therapy are needed. 6. We need better evidence on how to deal with prophylaxis after needlestick injuries, but in the meantime they should be treated with urgency with combination therapy given as soon as possible. 7. Costs will rise due to increased drug costs and better survival.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.nhsconfed.net/shpic/doc07.htm

Year Published: 1997

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Scotland, United Kingdom

Organisation Name: Scottish Health Purchasing Information Centre

Copyright: Scottish Health Purchasing Information Centre