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Canadian Journal of Infectious Diseases and Medical Microbiology
Volume 17, Issue 3, Pages 155-163
Special Article

Canadian Consensus Recommendations for the Optimal Use of Enfuvirtide in HIV/AIDS Patients

Anita Rachlis,1 Jonathan Angel,2 Marianne Harris,3 Richard Lalonde,4 Fiona Smaill,5 Cecile Tremblay,6 Chris Tsoukas,7 and Sharon Walmsley8

1Division of Infectious Diseases, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
2Division of Infectious Diseases, Department of Medicine, Ottawa Hospital and University of Ottawa, Ottawa, Ontario, Canada
3AIDS Research Program, St Paul’s Hospital, Vancouver, British Columbia, Canada
4Immunodeficiency Service and Division of Infectious Diseases, McGill University Health Centre, Montreal, Quebec, Canada
5Department of Pathology and Molecular Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
6UHRESS, Centre Hospitalier de l’Université de Montréal, Canada
7Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada
8Division of Infectious Diseases, Department of Medicine, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada

Received 28 November 2005; Accepted 28 April 2006

Copyright © 2006 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


BACKGROUND AND OBJECTIVES: An eight-member group consisting of Canadian infectious disease and immunology specialists and a family physician with significant experience in HIV management was convened to update existing recommendations, specifically intended for use by Canadian HIV-treating physicians, on the appropriate use of enfuvirtide in HIV/AIDS patients with resistance to other antiretroviral drugs.

METHODS: Evidence from the literature and expert opinions of the group members formed the basis of the guidelines. Comments on the draft guidelines were obtained from other physicians across Canada with HIV expertise. The final guidelines represent the group's consensus agreement.

RESULTS AND CONCLUSIONS: The recommendations were developed to guide physicians in optimal practices in patient selection for enfuvirtide treatment and subsequent patient management. The issues considered include positive predictors of response to enfuvirtide, stage of disease, optimization of the background regimen, early indicators of enfuvirtide response, and patient education and support.