HHS Adult and Adolescent Antiretroviral Treatment Guidelines Updated
The HHS Panel on Antiretroviral Guidelines for Adults and Adolescents (the Panel) has released an updated version of the Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents Living with HIV
Key guideline updates include the following:
In the What to Start section, antiretroviral therapy (ART) regimens recommended for initial therapy were originally classified as "Recommended," "Alternative," or "Other Regimens." In the updated guidelines, regimens are now either "Recommended Initial Regimens for Most People with HIV" or "Recommended Initial Regimens in Certain Clinical Situations."
In the What Not to Use section, the Panel now emphasizes that monotherapy with any antiretroviral (ARV) drug should not be used due to increased risk of virologic failure and drug resistance.
A new table in the Virologic Failure section provides guidance on ARV options for patients experiencing virologic failure.
Several studies have shown that persons with HIV who have sustained viral suppression with no drug resistance may be maintained on regimens with only two active drugs. Results from clinical trials using two-drug maintenance therapy are discussed in the Regimen Switching in the Setting of Viral Suppression section.
Both the Hepatitis B Virus (HBV)/HIV Coinfection and Hepatitis C Virus (HCV)/HIV Coinfection sections have been updated to discuss reactivation of HBV infection in persons with HBV/HCV coinfection after starting interferon-free HCV therapy.
The Adherence to Antiretroviral Therapy section has been extensively revised to discuss adherence to the entire HIV care continuum. As such, the title of this section has been changed to Adherence to the Continuum of Care.
In the drug interaction tables found in the Drug Interaction section, a number of drug classes have been added or expanded, including oral anticoagulants, new oral hypoglycemic agents, and hormonal therapy for menopausal management and for gender affirmation.
In addition, the guidelines now use People-First Language. People-First Language is a way of reducing stigma and showing respect for individuals who are living with HIV by focusing on the person instead of the disease.
For a complete list of guideline updates, please see What's New in the Guidelines
To view or download the guidelines, go to the Adult and Adolescent ARV Guidelines section of AIDSinfo
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