Nurseweek/Healthweek | Guidelines on protease inhibitors published

Guidelines on protease inhibitors published

posted 6-13-97

The first federal guidelines on using protease inhibitors to treat the HIV virus are expected to be published the third week of June by a panel of AIDS experts convened by the U.S. Department of Health and Human Services (HHS).

The guidelines will give physicians a comprehensive set of clinical practices to provide state-of-the-art options and guidance, said Damon Thompson, spokesperson for the HHS’s Office of Public Health and Science. The report outlines practice recommendations for physicians and incorporates principles of treating HIV.

HHS officials would not comment on the specific recommendations of the report, saying it was still under last-minute revision.

Two AIDS researchers who have seen drafts of the report applaud the panel’s recommendations, which they described as aggressive but in line with what most physicians recommend.

The draft report recommends using a combination of two nucleoside analogs and one protease inhibitor to aggressively lower viral load levels. "That’s consistent with our practice," said Henry Chang, research director at the AIDS Healthcare Foundation in Los Angeles. "Some critics say the regimen is too complicated, requiring swallowing up to 26 pills a day. What if the patient doesn’t comply? But to us, what can be more toxic than HIV infection?" Chang said.

Ruben Gamundi, head of treatment education at AIDS Project Los Angeles, agreed that the guidelines he has seen are appropriate, but said some physicians may not think they are aggressive enough. Gamundi said that by setting standard treatments the guidelines should help HIV patients whose insurance companies refuse to cover certain medications or lab tests.