n CME : Your SA Journal of CPD - The art of HAART : a practical approach to antiretroviral therapy : main topic




HAART is very effective treatment for advanced (CD4 count < 200 cells/µl) or symptomatic HIV infection. <br>Once initiated, HAART must be continued for life. <br>Dual therapy should never be prescribed as the benefits are transient and resistance develops quickly. <br>Before committing to HAART patients should have come to terms with their HIV infection and should have the support of family or friends. <br>Psychological issues and depression should be addressed before HAART is commenced. <br>In advanced HIV infection the risk of side-effects from HAART is outweighed by the benefits of viral suppression. <br>The importance of strict adherence to a HAART regimen should be emphasised, and problems that may compromise adherence should be managed proactively. <br>Clinicians should have a high index of suspicion for ART-induced drug side-effects, especially for lactic acidosis / acidaemia, which has very nonspecific symptoms including fatigue, weight loss, nausea, dyspnoea and abdominal pain.


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