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HIV/AIDS research and information
This page has links to a range of research and related information on HIV and AIDS.
This website provides a large number of articles on most aspects of HIV.
Antiretroviral treatment in adult HIV infection
Antiretroviral therapy has progressed rapidly over the past decade and has achieved remarkable reductions in HIV-related mortality in most developed countries with ready access to drugs. The pace of change is so great that treatment guidelines require frequent revision.
A recently published set of guidelines provides up-to-date recommendations. The article was convened by the USA Department of Health and Human Services. These Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents are available from AIDSinfo.
HIV antiretroviral drug resistance testing
Despite the increasing number of antiretroviral (ARV) agents to treat HIV infection, treatment failure is still occurring. Although there are many contributing factors to treatment failure, resistance of HIV to ARV therapy is of major importance. The following websites provide up-to-date information:
- Stanford Drug Resistance Database
- This research-oriented site offers software that allows uploading of a sequence text file to a drug resistance interpretation algorithm.
- HIV InSite – Links: Resistance and Resistance Testing
- This page provides links to several resistance-related sites including some commercial sites.
- National Serology Reference Laboratory
- This site provides the current algorithm for resistance mutation interpretation used by Australian and New Zealand laboratories involved in the 'Can Resistance Enhance Selection of Therapy' (CREST) study.
HIV specialist contacts
The HIV specialists listed below can be contacted by medical and healthcare professionals for advice on the management of HIV infected individuals. This also includes the management of HIV infected women in pregnancy and the prevention of mother-to-child transmission of HIV.
The contacts are:
- Dr Lesley Voss, Paediatrician, 09-379-7440,
- Dr Mark Thomas, Consultant Physcian in Infectious Diseases, 09-379-7440.
The 2009 Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents address 17 categories of opportunistic infections. They are endorsed by numerous organisations and disseminated widely, providing a new standard of care for HIV-infected people.
The Sanford Guide to Antimicrobial Therapy 2011, 41st edition, is an abbreviated intended for bedside clinical management decisions. It is available in print and web editions
Occupational exposures should be considered urgent medical concerns to ensure timely post-exposure management and administration of HBIG, hepatitis B vaccine and/or HIV PEP.
The U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HIV and Recommendations for Postexposure Prophylaxis updates and consolidates all previous US Public Health Service recommendations for the management of health care personnel (HCP) who have occupational exposure to blood and other body fluids that might contain hepatitis B virus (HBV), hepatitis C virus (HCV) or human immunodeficiency virus (HIV).
The most effective methods for preventing human immunodeficiency virus (HIV) infection are those that protect against exposure to HIV. Some health care providers have proposed offering antiretroviral drugs to persons with unanticipated sexual or injecting drug use HIV exposure to prevent transmission. However, because no data exist regarding the efficacy of this therapy for persons with non-occupational HIV exposure, it should be considered an unproven clinical intervention.
The Centers for Disease Control and Prevention provide guidelines on Antiretroviral Postexposure Prophylaxis After Sexual, Injection-Drug Use, or Other Nonoccupational Exposure to HIV in the United States.
HIV/AIDS in children
The general principles of therapy in HIV-infected adults, adolescents and children are similar but there are many unique aspects that are covered in these specific paediatric references.
AIDSinfo publishes the Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection. This is a comprehensive guideline on the use of antiretroviral drugs in HIV infected children and infants. It is an essential tool for any medical professional caring for children with HIV infection.
The American Academy of Pediatrics has written a number of statements on specific issues around HIV in children which are published intermittently in the journal Pediatrics. These are available from the Pediatric AIDS website.
HIV in pregnancy and perinatal HIV
These following two guidelines are very similar, with the first being from the British HIV Association and the second from the United States Public Health Service task force.
- Management of HIV infection in pregnant women (2008)
- Recommendations for Use of Antiretroviral Drugs in Pregnant HIV-1-Infected Women for Maternal Health and Interventions to Reduce Perinatal HIV Transmission in the United States
The British guidelines cover areas such as discordant couples and psychological issues and have ‘levels of evidence’. The United States guidelines are a complete review of antiretroviral therapy in pregnant HIV infected women as well as mode of delivery. Both cover issues for the neonate. Reading at least one of these is essential for the medical professional directly involved in the care of an HIV-infected pregnant woman.
HIV infection in women
Several early studies suggested a more aggressive natural history of HIV infection in women with shortened survival times but more recent studies have found the rate of clinical progression is similar between men and women if they receive comparable care. Currently, recommended treatment guidelines are identical for men and women.
The same issues are also covered by a very practical review article which emphasises that gynaecological infection is the most common reason for initial medical presentation in HIV positive women. Evaluation and Management of HIV-Infected Women, by Alexandra M. Levine, is available from the Annals of Internal Medicine.
The US Centers for Disease Control and Prevention guidelines recommend a cervical smear test should be obtained twice in the first year after diagnosis of HIV infection and, if the results are normal, annually thereafter. HIV infection is not an indication for colposcopy in positive women who have normal smear test results.
In New Zealand, the National Cervical Screening Programme also recommends annual cervical smears for women with HIV infection. If the smear results are abnormal, care should be provided according to the Guidelines for Cervical Screening.
Complementary therapies and HIV
AIDS Community Research Initiative of America article: ACRIA Update: Summer 1999 'Complementary Medicine and HIV: A New Age'
Other sites with complementary therapies and HIV information include:
- The Network and Housing Works Access to Care
- AIDS Treatment News
- Healing Well – AIDS
- National Institutes of Health
General websites on complementary medicine:
HIV and nutrition
- The Body – Diet, Nutrition, Exercise and HIV
- The Body – Nutrition and HIV – Your Choices Make a Difference
- The Body – CDC FAQ about HIV/AIDS and Nutrition
- HIV Nutrition Resources
HIV and recreational drugs
- Community Alcohol and Drug Services
- Drug Interactions
- Green Cross Medical Cannabis Support Group
- The Body – Warning: Ritonavir and Ecstasy
- The Body – Anti-HIV Medication + Street Drugs: Some Cocktails Don’t Mix
The Rodger Wright Centre in Christchurch provides New Zealand-based information on both HIV and drug use.
Voluntary counselling and testing for diagnosis of HIV infection
The Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings contains the most recent set of guidelines on HIV testing produced by the US Centers for Disease Control. It provides an excellent, comprehensive, evidence-based summary of best practice with regard to HIV counselling, testing and referral.