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    Guidelines for antiretroviral therapy in adults by the Southern African HIV clinicians society

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    These guidelines are intended as an update to those published in the Southern African Journal of HIV Medicine in January 2008. Since the release of the previous guidelines, the scaleup of antiretroviral therapy (ART) in Southern Africa has continued to grow. Cohort studies from the region show excellent clinical outcomes; however, ART is still being started late (in advanced disease), resulting in relatively high early mortality rates. New data on antiretroviral (ARV) tolerability in the region and several new ARV drugs have become available. Although currently few in number, some patients in the region are failing protease inhibitor (PI)- based second-line regimens. To address this, guidelines on third-line (or ‘salvage’) therapy have been expanded.Specific recommendations provided here are intended only as a guide to clinical therapy, based on expert consensus and best current evidence. Treatment decisions for patients should be made by their responsible clinicians, with due consideration for individual circumstances. The most current version of this document should always be consulted.All expert panel members have completed and submitted conflict of interest disclosure forms. Disclosure information represents the previous 3 years (updated 17 August 2012) and includes relationships with pharmaceutical companies and medical aids: Dr Francesca Conradie has received support from Abbott to attend conferences, and research support from Tibotec. She has also received honoraria for speaking engagements from Abbott and MSD. Dr Hefer has received support to attend conferences from Abbott, Adcock Ingram, Aspen and MSD. He owns shares in Lifecell and has received honoraria for speaking engagements from Abbott, Aspen and MSD. Dr Johnson has received research support from Bristol Myers Squibb (BMS), MSD, Tibotec and Schering-Plough. He has also received honoraria for speaking engagements from Abbott. Professor Graeme Meintjes has received honoraria for speaking engagements from Sanofi Aventis and serves as a consultant for Aid for AIDS. Professor Yunus Moosa has received support to attend conferences from Abbott and honoraria for speaking at conferences/seminars from Abbott, Aspen, MSD and Pfizer. Dr Theresa Rossouw serves as a consultant for Discovery Health. Dr Ebrahim Variava receives support for clinical trials from Outsuka. Professor Francois Venter has received support to attend conferences from Adcock Ingram and MSD; honoraria for speaking engagements from MSD; and has served as a consultant for Abbott, Johnson and Johnson and Tibotec. Dr Eric Goemaere, Professor Gary Maartens, Dr Moeketsi Mathe, Dr Regina Osih and Dr Gilles Van Custem report no conflicts of interest.This work is supported and funded by the Southern African HIV Clinicians Society through an educational grant from Atlantic Philanthropies.www.sajhivmed.org.zaam201
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