CBO-richtlijn: 'Antiretrovirale behandeling in Nederland'

In collaboration with the Dutch Institute for Health Care Improvement (CBO) and on the basis of recent developments, new guidelines have been developed for the diagnosis and treatment of HIV-infected patients. The most important recommendations are: - Treatment of adult patients is indicated if HIV load > 30,000 RNA copies/ml, or when CD4+ cell count is 5,000 copies/ml, even when CD4+ cell count is > 500 x 106 cells/l. - Optimal antiretroviral treatment consists of a combination of two nucleoside reverse transcriptase inhibitors (NRTIs) and one protease inhibitor, or a combination of two NRTIs and one non-nucleoside reverse transcriptase inhibitor. - Patients on antiretroviral treatment should be monitored every 3 months. - Undetectable HIV load should be the target of first- or second-line antiretroviral treatment. - In order to prevent HIV transmission from mother to child, prescription of antiretroviral drugs after the first three months of pregnancy is indicated in pregnant women with a detectable HIV load. - Prophylaxis of opportunistic infections can be discontinued if CD4+ cell count recovers above 200 × 106/l. - In case of exposure to HIV due to a needle or other occupational accident or unsafe sexual contact, post-exposure prophylaxis should be offered after careful risk evaluation. - Preferably, vaccination to prevent pneumococci infections, influenza, hepatitis A or hepatitis B should be given when CD4+ cell count is > 200 x 106/l

Update richtlijn psoriasis 2017

The update of the NVDV guideline psoriasis 2017 is summarized. In the update the chapters methotrexate, fumaric acid esters, biologics, children, serum concentrations and antibody formation and quality of life are renewed. In addition chapters on secukinumab, apremilast, choice of treatment, combination treatment, psoriatic arthritis and pregnancy and breastfeeding during biologic treatment have been added. The update is based on the NVDV guideline psoriasis 20111, European Dermatology Forum (EDF) guideline Psoriasis 20152 and new search and analyses by the workgroup. The most important differences in the update 2017 compared to the NVDV guideline psoriasis 2011 are discussed

The burden of rheumatoid arthritis and access to treatment: a medical overview

Rheumatoid arthritis, A, A1, A10, A31, I11,