ART Guidelines
Table of Contents
How to use these guidelines
Abbreviations
MODULES
1. What’s new the 2023 guidelines update?
2. Nucleoside/nucleotide reverse transcriptase inhibitor class of antiretroviral drugs
3. Integrase strand transfer inhibitor class of antiretroviral drugs
4. Non-nucleoside reverse transcriptase inhibitor class of antiretroviral drugs
5. Protease inhibitor class of antiretroviral drugs
6. Initiation and timing of antiretroviral therapy
7. Baseline investigations
8. Viral load
9. CD4+ cell count
10. Resistance and genotyping
11. Initial antiretroviral therapy regimens for the previously untreated patient
12. Management of patients currently receiving first-line therapy
13. Management of patients starting or currently receiving second-line therapy
14. Third-line antiretroviral therapy
15. Laboratory monitoring of the efficacy and safety of antiretroviral therapy
16. Patients who return after stopping antiretroviral therapy
17. Drug-drug interactions
18. Tuberculosis
19. Pregnancy and breastfeeding
20. Liver disease
21. Renal disease
22. Psychiatric disease
23. Malaria
24. Antiretroviral drug-induced liver injury
25. Dyslipidaemia
26. Immune reconstitution inflammatory syndrome
27. Opportunistic infection prophylaxis
28. Adherence
References
References
WHAT’S NEW IN THE 2023 GUIDELINES UPDATE?
Key updates
- Recommendation to shift most patients to a dolutegravir-based regimen if possible (see modules 12-14).
- For patients requiring a protease inhibitor (PI), recommendation for darunavir as the PI of choice, and for lopinavir/ritonavir to only be considered where a PI is required to be coadministered with rifampicin-based tuberculosis treatment (see modules 5 and 13).
- New recommendations on the move away from routine use of zidovudine (AZT) in second-line therapy in favour of recycling tenofovir or, in patients with renal dysfunction, abacavir (see module 13).
- Advice on how to assess the increase in serum creatinine seen with dolutegravir/tenofovir fixed dose therapy (see module 3).
- Guidance on the role of tenofovir alafenamide; TAF (see modules 2 and 11).
- Inclusion of enhanced baseline screening for tuberculosis and sexually transmitted infections (see module 7)
- Expansion of the module on HIV and mental health (see module 22).