[Management of HIV infected patients: applicability of guidelines. Results of an nationwide Austrian survey].
BACKGROUND
Antiretroviral treatment and prophylaxis in HIV-infected patients follows guidelines. Aim of the study was to evaluate to what extent guidelines are useful. We used a cohort of patients (I) and a nationwide audit (II).


METHODS
Over a 48-month period demographic data, immunologic function and stage of HIV-infection of 433 patients were recorded (I). Questionnaires about the practicability of antiretroviral therapy according to recently published guidelines were mailed to experienced hospital departments and private offices (II).


RESULTS
I. In 307 of 433 (70.9%) patients antiretroviral therapy and in 107 of these 433 (24.7%) patients primary prophylaxis against PC-infection could be initiated according to the guidelines. In 21 of 433 patients (4.8%) Ganciclovir prophylaxis was applicated using Port-a-Cath systems in a homecare setting. II. In Austria 118 questionnaires were mailed in June 1996, 43 (36.4%) were returned and 38 could be evaluated. 1450 patients were treated by physicians, who answered the questionnaires, 78.1% of these worked in hospitals and 78.9% were specialists. 75% of the physicians had experience with HIV-infected patients exceeding 5 years. CD4+ lymphocyte count was routinely done in 73.7% of the physicians, viral load only in 42.1%. These examinations were predominantly performed in hospitals (in 64.3% and 81.2%, respectively). Only 13/36 of the physicians prescribed the recommended combination therapy consisting of 2 nucleosides and 1 protease-inhibitor. 5/6 hospitals and 4/8 private offices in Vienna and 6/12 hospitals outside of Vienna used proteaseinhibitors.


CONCLUSIONS
Antiretroviral treatment according to the guidelines published recently, is only possible in centres for the treatment of HIV-infected patients at the moment.
Armbruster
C
C
II. Interne Abteilung des Pulmologischen Zentrums der Stadt Wien.
Gmeinhart
B
B
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy*; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D001317:Austria; D018791:CD4 Lymphocyte Count / Q000187:drug effects; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008485:Medical Audit; D017410:Practice Guidelines as Topic; D016896:Treatment Outcome; D019562:Viral Load
D019380:Anti-HIV Agents
Management HIV-infizierter Patienten: Anwendbarkeit von Richtlinien. Ergebnisse einer österreichweiten Umfrage.