The HHS Panel on Antiretroviral Guidelines for Adults and Adolescents announces the release of the updated Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents. Most notably, the approval of 3 fixed-dose combination products containing tenofovir alafenamide (an oral prodrug of tenofovir) and emtricitabine (TAF/FTC) prompted several guideline updates.
Key guideline updates include the following:
- In the What to Start section, TAF/FTC was added as a 2-NRTI option in several Recommended and Alternative Regimens. Other updates include the addition of guidance for clinicians when choosing between ABC-, TAF-, and TDF-containing regimens and the removal of the lopinavir/ritonavir (LPV/r) plus 2-NRTI regimen from the list of Other regimens.
- Reflecting the most current data, the Regimen Switching section was simplified to focus on switch strategies for virologically suppressed patients.
- In the HIV and Women section, the Panel emphasizes that ART is recommended for all HIV-infected patients, including all HIV-infected women, and stresses the importance of early treatment for HIV-infected women during pregnancy and continuation of ART after pregnancy.
- Changes to the Hepatitis B (HBV)/HIV and Hepatitis C (HCV)/HIV Coinfection sections include the addition of TAF/FTC as an option to treat HBV/HIV coinfection and updated information on interactions between ARVs and the recently approved HCV drugs daclatasvir and the fixed-dose combination elbasvir/grazoprevir.
- A discussion on the treatment of latent tuberculosis infection (LTBI) in HIV-infected persons is now included in the Tuberculosis (TB)/HIV Coinfection section. The added discussion notes that a 12-week course of once-weekly rifapentine and isoniazid is an option for patients receiving either an efavirenz- or a raltegravir-based regimen.
For a complete preview of key updates to the guidelines, please see What's New in the Guidelines. Additions and revisions are also highlighted in yellow throughout the text and tables of the PDF version of the guidelines.
To view or download the guidelines, go to the Adult and Adolescent ARV Guidelines section of AIDS_info_. Separate PDF files of only the guideline tables or the boxed recommendations can also be downloaded from the page.
Forward Comments on the Revised Guidelines to AIDS_info_
Feedback on the revised Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents is welcome. Please email your comments with the subject line "Comments on the Adult and Adolescent ARV Guidelines" to ContactUs@aidsinfo.nih.gov by July 28, 2016.