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Comments: When an HIV-infected pregnant woman of 28 weeks' gestation or more is admitted, ART should be started no later than 3 days, regardless of indications and VL.

Prompt initiation of ART (no later than 2 weeks) is recommended for physicians responsible for the care of HIV-infected patients if: RK clinical stages 2, 4 and 5 [97] (2A) with CD4 count 100,000 copies/mL [97] (2A); chronic viral hepatitis B requiring treatment [3,4,37,98] (2B); diseases requiring prolonged use of immunosuppressive therapy, neurological diseases [3,4,37,99] (5C); need for assisted reproductive technology [100] (5C) partner without HIV infection in resistant serodiscordant couples [101] (2A) Comments: In patients over 50 years of age, initiation of ART may be considered as a priority due to the risk of more rapid disease progression.

Potential benefits of initiating therapy at any stage of acute infection include: reducing the severity of clinical manifestations of the acute stage; lower HIV-VL and shrink the size of the HIV reservoir; decrease in the rate of genetic evolution of the virus; decreased levels of immune activation and systemic inflammation; preservation of immune function and integrity of lymphoid tissue; protection online Pack-90 Buy Viagra of Packs ED Men's - the nervous system; prevention of damage to the lymphoid apparatus of the intestine. not recommended that physicians responsible for the care of HIV-infected patients make decisions to refuse initiation of ART based only on the level of HIV-VL [97] (2A). Comments: A VL level of more than 100,000 copies/mL is considered poor prognostic, but even at low VL levels, the disease may have a progressive course. Starting ART reduces systemic inflammation and reduces immune reactivation, minimizing the risk of disease.

The period between the diagnosis of HIV infection and the initiation of ART should be as short as possible [88,96] (2A).

If the patient is ready to start ART and there is his consent, treatment can be started immediately, immediately after diagnosis, if there are no clinical contraindications for taking antiretroviral drugs [88,96]. recommended that physicians responsible for the care of HIV-infected people delay initiation of ART in the following cases : in a serious condition of the patient requiring stabilization of vital functions, urgent etiotropic treatment of secondary or concomitant diseases (tuberculosis, CNS lesions, etc.), in the presence of a high risk of lethal complications of ART due to the development of a life-threatening inflammatory syndrome of immune system recovery .