AIDS group issues
HIV treatment guidelines for Katrina evacuees

The American Academy of HIV Medicine has issued recommendations for the treatment and care of HIV-positive people forced to relocate due to Hurricane Katrina. The guidelines, released in a document titled "Recommendations for the Triage of HIV+ Patients," are intended for physicians who may not have extensive experience in treating HIV patients and who practice in areas with large numbers of evacuees.

According to the document, the following steps are recommended:

* The first priority is to treat active opportunistic infections or any other infection with antibiotics or other appropriate medication.

* Physicians should try to determine each patient's CD4-cell count, as varying counts put them at risk for different opportunistic infections the patient should be screened for, like HIV-related pneumonia for those with counts under 200; histoplasmosis, toxoplasmosis, and cryptococcal meningitis for those with counts under 100; and mycobacterium avium complex and systemic fungal disease for those with counts under 50.

* If there's a choice between getting antiretroviral medications or prophylactic drugs to prevent opportunistic infections, doctors should get the anti-HIV drugs first to avoid treatment interruptions. But both courses of medication should be continued if possible.

* If patients cannot obtain all their antiretroviral drugs, every drug should be stopped, rather than continuing just one or two.

* HIV-positive people should receive tetanus shots.

* Live-virus vaccines should be used with caution in HIV patients, but those with CD4-cell counts above 350 should experience no problems.

The guidelines also include sections on which anti-HIV drugs to consider and which combinations to avoid; treating pregnant women; using anti-HIV drugs to prevent HIV disease after possible exposure to the virus; and rapid HIV antibody testing.

For HIV-positive people displaced by Hurricane Katrina, AAHIVM recommends locating a local HIV specialist or treatment clinic by going online to www.aahivma.org.

For more information on treating HIV patients, go online to www.aahivma.org or to the National Institutes of Health's Web site at www.aidsinfo.nih.gov/guidelines.