On July 14, 2016 the DHHS Guidelines for the Use of Antiretroviral Agents in HIV Infected Adults and Adolescents were updated from the prior revision January 28,2016.
So what’s New?
What To Start: Initial Regimens for Antiretroviral Naïve Patients
TAF/FTC (the new tenofovir alafenamide) was added in several recommended and alternative regimens
- Simplified and focuses on switch strategies for people who are virologically suppressed
HIV Infected Women
- The Panel emphasizes that ART is recommended for all HIV-infected patients, including all HIV-infected women
- The Panel also stresses the importance of early treatment for HIV-infected women during pregnancy and continuation of ART after pregnancy.
- This section was updated to include new data on interactions between antiretroviral (ARV) drugs and hormonal contraceptives.
Hepatitis B and HIV Coinfection
- This section was updated to include TAF/FTC as a treatment option for people coinfected with HIV and Hepatitis B.
- Adefovir and telbivudine are no longer recommended as options for HIV/HBV coinfection as they have a higher incidence of toxicities than other recommended regimens
Hepatitis C and HIV Coinfection
- Drug interactions between different antiretroviral drugs and recently approved Hep C drugs daclatasvir (daklinza) and the fixed dose combination product elbasvir and grazoprevir (Zepatier) has been updated.
- Inteferon and ribavirin were removed from the drug interaction list as they have no significant interactions with antiretroviral drugs
There were also some updates made to TB/HIV Coinfection section as well as the following:
- lab testing
- drug resistance testing
- Side Effects of ARV
- monthly average wholesale price of commonly used ARV
- drug interactions
The IAS-USA also updated their guidelines for Antiretroviral Drugs for Treatment and Prevention of HIV Infection in Adults in JAMA (Journal of the American Medical Association) on July 12,2016.