HIV/AIDS

Updated recommendations on first-line and second-line antiretroviral regimens and post-exposure prophylaxis and recommendations on early infant diagnosis of HIV

Interim guidance

Authors:
WHO

Updated recommendations on first-line and second-line antiretroviral regimens and post-exposure  prophylaxis and recommendations on early infant diagnosis of HIV: interim guidance - December 2018

Publication details

Number of pages: 82
Publication date: December 2018
Languages: English
WHO reference number: WHO/CDS/HIV/18.51

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Overview

Update on recommendations on antiretroviral regimens for treating and preventing HIV infection: In 2016, WHO published the consolidated guidelines on the use of antiretroviral (ARV) drugs for treating and preventing HIV infection and recommended tenofovir disoproxil fumarate (TDF) + lamivudine (3TC) (or emtricitabine, FTC) + efavirenz (EFV) 600 mg as the preferred first- line antiretroviral therapy (ART) regimen for adults and adolescents. Since that time, scientific evidence and programmatic experience have accumulated on the use of dolutegravir (DTG) in both first- and second-line ART, including during pregnancy and tuberculosis co-treatment, and for children. In 2018, these guidelines were reviewed to provide updated guidance on preferred option for these populations which now include DTG and raltegravir (RAL), and updated recommendations on using ARV drugs for HIV post-exposure prophylaxis. Annex 3 above links to the ARV dosing guidance for children, adolescents and adults.

Update on early infant diagnosis of HIV: Since 2010, WHO has been recommending that HIV virological testing be used to diagnose HIV infection among infants and children younger than 18 months and that ART be started without delay while a second specimen is collected to confirm the initial positive virological test result. Since that time, evidence has been reviewed and in light of reducing mother-to-child transmission rates and thus decreasing positive predictive values, an indeterminate range to support more accurate early infant diagnosis is recommended.

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