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Recommendations From a State-of-the-Art Conference

Merle A. Sande, MD; Charles C. J. Carpenter, MD; C. Glenn Cobbs, MD; King K. Holmes, MD, PhD; Jay P. Sanford, MD; the National Institute of Allergy and Infectious Diseases State-of-the-Art Panel on Anti-Retroviral Therapy for Adult HIV-lnfected Patients; Merle A. Sande, MD; Charles C. J. Carpenter, MD; C. Glenn Cobbs, MD; Robert W. Coombs, MD, PhD; Thomas R. Fleming, PhD; King K. Holmes, MD, PhD; Rebecca Denison; Mitchell H. Gail, MD, PhD; Wayne Lamar Greaves, MD; Martin S. Hirsch, MD; Roberta Luskin-Hawk, MD; Donna Mildvan, MD; Charles A. Nelson; John P. Phair, MD; Jay P. Sanford, MD; Robert Schooley, MD; R. Gabriel Torres, MD; Robert Vazquez; Lawrence Deyton, MSPH, MD; John Jermano, RN, MPH; Juanita Koziol, RN, MS, CS; Carla Pettinelli, MD, PhD; Debbie Katz, RN, MS

JAMA. 1993;270(21):2583-2589.

Abstract
This document summarizes recommendations from a state-of-the-art conference convened to evaluate the role of nucleoside analogue reverse transcriptase inhibitors in the treatment of human immunodeficiency virus (HIV) infection. Data from controlled clinical trials of zidovudine, didanosine, and zalcitabine were reviewed by an expert panel, which then formulated guidelines to assist clinicians and HIV-infected patients in the use of these agents. Recommendations were framed in the context of clinical scenarios for patients with asymptomatic HIV infection who have not had prior antiretroviral therapy; those with signs and symptoms of HIV-related disease who have not received prior therapy; clinically stable patients who are tolerating initial zidovudine therapy; patients experiencing clinical progression while on zidovudine therapy; and those who are intolerant of antiretroviral therapy. The panel concluded that physicians need to integrate up-to-date scientific knowledge with other relevant needs to improve the care of HIV-infected patients.

(JAMA. 1993;270:2583-2589)

Author Affiliations
University of California, San Francisco; Brown University, Providence, RI; Veterans Affairs Medical Center, Birmingham, Ala; University of Washington, Seattle; Women Organized to Respond to Life-Threatening Diseases, Oakland, Calif; National Cancer Institute, Rockville, Md; Howard University, Washington, DC; Harvard University, Boston, Mass; Saint Joseph Hospital & Health Care Center, Chicago, Ill; Beth Israel Medical Center, New York, NY; ACTG Community Constituency Group, Atlanta, Ga; Northwestern University, Chicago, Ill; University of Texas, Dallas; University of Colorado, Denver; New York (NY) Medical College; Minority Task Force on AIDS, New York, NY; Community Clinical Research Branch; Medical Branch; Office of the Director

From the Department of Medicine, University of California, San Francisco (Dr Sande), Division of Biology and Medicine, Brown University School of Medicine, Providence, RI (Dr Carpenter), Department of Veterans Affairs Medical Center, Birmingham, Ala (Dr Cobbs), University of Washington, Center for AIDS and Sexually Transmitted Diseases, Seattle (Dr Holmes), and Department of Internal Medicine, University of Texas, Dallas (Dr Sanford).

Footnotes
A complete list of the State-of-the-Art Panel and National Institute of Allergy and Infectious Diseases Planning Committee appears at the end of this article.

Reprint requests to Office of Communications, Bldg 31A, Room 7A50, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892 (Patricia Randall).

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