The up-to-date guideline for the ART (ant-retroviral treatment) of HIV/AIDS will be discussed inthis session, which includes –Acute and Recent (Early) HIV Infection, When and What to Start (Initial Combination Regimen for Antiretroviral-Naive Patients), and HIV-Infected Women.

The term “early” HIV infection is now used when describing both the acute phase of HIV infection (i.e., immediately after HIV infection and before seroconversion) and recent (i.e., within first 6 months) HIV infection. The recommendation for initiation of ART in patients with early infection was changed from “should be considered optional to “should be offered.” The issue for the prospect of the cure of HIV/AIDS will be illustrated from recent two cases.

The evolutional concept of ARV for asymptomatic HIV-infected patients will be presented. ART is now recommended for all HIV-infected individuals to reduce the risk of disease progression. ART also is recommended for HIV-infected individuals for the prevention of transmission of HIV, including perinatal transmission, heterosexual transmission and other transmission risk groups. Patients starting ART should be willing and able to commit to treatment and understand the benefits and risks of therapy and the importance of adherence. Patients may choose to postpone therapy, and providers, on a case-by-case basis, may elect to defer therapy on the basis of clinical and/or psychosocial factors.

For HIV-Infected Women, it is recommended that intravenous zidovudine use during labor may be omitted in women who have HIV RNA < 400 copies/mL near delivery. Oral combination ART should be continued during labor. Upon the recommendation on use of efavirenz (EFV) during pregnancy was updated because the risk of neural tube defects is restricted to the first 5 to 6 weeks of pregnancy and pregnancy is rarely recognized before 4 to 6 weeks of pregnancy, EFV can be continued in pregnant women receiving an EFV-based regimen who present for antenatal care in the first trimester, provided the regimen produces virologic suppression.

Meanwhile, the ART guideline of Taiwan CDC will be further introduced and addressed. Upon pharmaco-economic consideration, the health authority implemented the ART guideline for the clinicians since June in 2012. The integration of up-to-date DHHS guideline and Taiwan CDC guideline for the clinical practice issue will be highlighted.