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Inpatient HAART protocol

The results of ACTG 5164 suggest that initiating HAART early after the initiation of treatment of an opportunistic infection (OI) may lead to fewer deaths and other AIDS defining illnesses. [Zolopa AR, Andersen J, Komarow L, Sanne I, Sanchez A, et al. (2009)]. Of note, the investigators excluded patients with tuberculosis and 86% of randomized patients had non-mycobacterial OIs (63% Pneumocystis pneumonia, 13% cryptococcal meningitis and 10% community-acquired pneumonias).

Because of these data medicine teams may want to initiate HAART while patients are inpatients.  When starting HAART on inpatients the following procedure should be followed:

• All patients should be followed by the ID consult service who will be involved in the decision to start HAART and the choice of regimen.
• The ID fellow should contact Gerald Tebo (gtebo@u.washington.edu; 744-2010) who will determine who will be the patient’s case manger.  The case manger will then orchestrate the in-hospital HAART appointments (nutrition, pharmacy, case management) and follow-up in the clinic