Optimal monitoring strategies for guiding when to switch first-line antiretroviral therapy regimens for treatment failure in adults and adolescents living with HIV in low-resource settings

Cochrane Database of Systematic Reviews, 2011

Optimal monitoring strategies for guiding when to switch first-line antiretroviral therapy regimens for treatment failure in adults and adolescents living with HIV in low-resource settings - The Cochrane Library - Chang - Wiley Online Library from LOGIN Enter e-mail address Enter password REMEMBER ME > > > > DATABASE TOOLS DATABASE MENU FIND ARTICLES OTHER RESOURCES Intervention Review You have full text access to this content Optimal monitoring strategies for guiding when to switch first-line antiretroviral therapy regimens for treatment failure in adults and adolescents living with HIV in low-resource settings Larry W Chang 1,* , Jamal Harris 2 , Eliza H Humphreys 3 Editorial Group: Published Online: 14 APR 2010 Assessed as up-to-date: 30 SEP 2009 DOI: 10.1002/14651858.CD008494 Copyright © 2011 The Cochrane Collaboration.
Optimal monitoring strategies for guiding when to switch first-line antiretroviral therapy regimens for treatment failure in adults and adolescents living with HIV in low-resource settings.
Publication History Publication Status: Edited (no change to conclusions) Published Online: 14 APR 2010 SEARCH ARTICLE TOOLS Abstract Abstract Background One of the critical clinical decisions made in antiretroviral therapy (ART) is when to switch from an initial regimen to another due to treatment failure.
This complex process requires consideration of multiple factors including: (1) what type of monitoring (e.g.
clinical, immunologic, virologic) is available to guide switching; (2) establishing criteria for treatment failure (e.g.
viral load >10,000 copies/mL); (3) integrating data from different types of monitoring; (4) making a decision; and, if possible, (5) follow-up and monitoring to determine patient outcomes. The initial step in this model of deciding when to switch is determining what type of monitoring for guiding when to switch is available and appropriate.
This review seeks to find and summarize evidence on optimal monitoring strategies for guiding when to switch first-line regimens due to treatment failure among adults and adolescents living with HIV in low-resource settings.
This review was one of a series of reviews prepared in 2009 at the request of the World Health Organization to inform the development of new guidelines on ART for adults and adolescents.
Objectives To assess optimal monitoring strategies for guiding when to switch antiretroviral therapy regimens for first-line treatment failure among adults and adolescents living with HIV in low-resource settings.
Search methods We formulated a comprehensive and exhaustive search strategy in an attempt to identify all relevant studies regardless of language or publication status.
In July 2009, we search the following electronic journal and trial databases: MEDLINE, EMBASE, CENTRAL.