DHHS guidelines: the most recent revisions. Department of Health and Human Services.

Recent guideline revisions within the Use of Antiretroviral Agents in Adults and Adolescents are discussed in the following areas: (1) use of soft-gel saquinavir (SGS) as a first line protease inhibitor, (2) the role of ultra-sensitive viral load assays, and (3) the use of d4T in pregnant women. Revisions suggest that SGS be combined with two nucleoside analogues. The standard dose is 1200 mg three times daily with meals. One revision, due to sensitivity of third generation assays, has reduced viral load thresholds of detection from 500 copies/ml to 20-50 copies/ml. However, the threshold for no detectable virus remains at 500 copies/ml. Finally, revisions support the inclusion of AZT in the antiretroviral regimen of pregnant women, but the combination of AZT with d4T should be avoided in pregnancy.