Summary of Changes from v.10.0 to v.10.1

The COVID-19 situation is rapidly changing, and evidence is constantly accumulating. Therefore, we refer to the regularly updated BHIVA, DAIG, EACS, GESIDA & Polish Scientific AIDS Society Statement on risk of COVID-19 for PLWH

ART section

  • What to start with, Initial Combination Regimen for ART-naïve Adult PLWH
    • New organization of treatment categories which are now divided into recommended regimens, alternative regimens and other combinations
    • Recommended regimens include unboosted INSTI (DTG, BIC or RAL) plus 2 NRTIs or 3TC/DTG
    • CD4 count restriction has been removed for 3TC/DTG
  • Switch strategies for virologically suppressed persons
    • DRV/b + DTG has been included as dual therapy option supported by small trials
  • Virological failure
    • Treatment recommendation wording has been changed to “New regimen will usually use at least 1 fully active PI/b (e.g. DRV/b) plus a drug remaining fully active despite resistance to other drugs from the class (e.g. INSTI, NNRTI) and/or from a class not used previously (e.g. INSTI, NNRTI, PI, CCR5 antagonist (if tropism test shows R5 virus only) assessed by genotypic testing”
  • Treatment of pregnant women living with HIV or women considering pregnancy
    • TAF has been removed from table 2 Antiretroviral drugs not recommended in women who become pregnant while on ART
    • TAF/FTC+DTG has been included as a recommended regimen in table 3 Antiretroviral regimen for ART-naïve pregnant women
  • Post-exposure prophylaxis (PEP)
    • ZDV/3TC has been removed from alternative regimens and DRV/b included

DDI section

  • All tables have been updated to include changes implemented in the HIV drug interaction website (University of Liverpool) in the past year. The most relevant changes include:

Co-morbidity section

Viral Hepatitis Co-infections section

Opportunistic Infections section

  • Some minor stylistic changes were made to all OI tables
  • Cidofovir was deleted from the list of drugs for secondary prophylaxis/maintenance therapy for CMV retinitis
  • Rifabutin was added to the list of drugs for primary prophylaxis of Non-Tuberculous Mycobacteria
  • Moxifloxacin was added to the list of drugs for treatment of MAC