HIV /AIDS: NEW GUIDELINE FOR STARTING FIRST LINE ARV MEDICINES 

PROF.DRRAM ,HIV/AIDS,SEX DIS.,SEX WEAK.& ABORTION SPECIALIST 
profdrram@gmail.com,+917838059592,+919832025033,DELHI –NCR,IND 
HIV/ AIDS,CANCER LATEST MEDICINES AVAILABLE AT CHEAP RATE. 
FOLLOW ON FACE BOOK:www.facebook.com/drramkumar 
FOLLOW ON TWITTER:www.twitter.com/profdrram 

AS THE NEW RESEARCH PROGRESS NOW NO FIXED FIRST OR SECOND LINE DRUG REGIME FOR HIV/AIDS PATIENTS,MANY DRUGS ARE AVAILABLE IN FIRST LINE , NOT AS IN OUR ART REGIME GIVE TWO,NNRTI ,ONE NNRTI COMPULSORY AS PROTEASE INHIBITOR ADDED IN SECOND LINE OR ADDING FUSION OR INTEGRASE INHIBITOR IS ALWAYS THIRD GENERATION DRUG ,NOW ANY THING CAN BE FIRST LINE AS STATED BELOW AND WILL BE DETERMINED BY PATIENT SYMPTOMS AND CHOICE BY DOCTOR SEEING MULTIPLE SIDE EFFECTS AND STATUS OF PATIENT LIKE BASELINE BLOOD COUNT, CBC,KFT,LIPID PROFILE,LIVER PROFILE AND CLINICAL CONDITION, AGE AND SEVERITY OF DISEASE AND ECONOMICAL CONDITION AND AVAILABILITY OF DRUG AND CHOIC BY PATIENT TOO.
NO MORE WHEN TO START THERAPY BASED ON CD4 COUNT,ANY TIME IF YOU ET POSITIVE HIV BY CONFORMED VIRAL LOAD,MEDICINE CAN BE STARTED AS WE START MEDICINE FOR CANCER OR DIABETES WHEN WE DETECT IT AND DONOT WAIT TILL IT IS ADVANCED OR DETERIOATE AND CAUSE MORE SUFFERINGS AND CO INFECTIONS OR OPPUTUNISTIC INFECTIONS OR SIDE EFFECTS INVOLVING OTHER BODY SYSTEM.

The revised guidelines, posted to AIDSinfo on May 1, represent the cumulative wisdom of a diverse panel of HIV experts convened by the U.S. Department of Health and Human Services (DHHS). This marks the first full update to the guidelines since Feb. 12, 2013.
Among the most noteworthy changes this time around:
There's no such thing as a "preferred" first-line regimen anymore. We now have so many viable options for people starting HIV treatment that calling all of them "preferred" apparently began to feel silly to the expert panel. Instead, we now have 10 different "recommended" regimens, and the value of each option will vary depending on the nuances of a person's health. There are also additional "alternative" regimens that are considered safe and effective, just not as widely useful (or well-proven) as the recommended regimens.
Three new "recommended" regimens have been added. All involve the use of new integrase inhibitors: Tivicay OR 572-Trii (dolutegravir) plus Epzicom (abacavir/3TC or lamivudine ), Tivicay plus Truvada (tenofovir/FTC OR EMTRICITABINE ) and Stribild (a fixed-dose, single-pill regimen consisting of elvitegravir, cobicistat tenofovir and FTC or emtricitabine ).
Many drugs have been removed from the guidelines entirely. We are now up to 33 individual drugs and drug combinations being actively manufactured and sold in the U.S. Not all of them are going to be ideal for first-line therapy, particularly not in comparison to newer medications. Fortovase/Invirase (saquinavir) boosted with Norvir (ritonaivir), Lexiva (fosamprenavir) boosted with Norvir (ritonavir), Retrovir (zidovudine, part of Combivir and Trizivir), Reyataz(Atazanavir) unboosted (it's still recommended if boosted with Norvir), Selzentry (maraviroc) and Viramune (nevirapine) have all been snipped off the guidelines' first-line drug lists.
Any Good drug combination like Raltegravir or Integrase given twice not single or Rilpivirne oer Endurant is better than toxic Nevirapine or delusion psychiatric producing symptoms of insomnia with efavirenz ,so Atripla or Trustiva or Viraday (Tenofovir+emtricitabine +efavirenz) is now less used than Complera (Rilprivine +tenofovir +emtricitabine)or Stribild (Tenofovir+emtricitabine+cobicistat+Elvitegravir) or 572-Trii (Dolutegravir + Abacavir +Lemovudine ) is better used as first line drug.
Classification as first or second line drug is not present and change of dru is done not for mere change but if clinical symptoms or viral load remais ood no change should be done.