Recommendations Provided for Treating, Preventing HIV
FRIDAY, Dec. 27, 2024 -- In a special communication issued by the International Antiviral Society-USA Panel and published online Dec. 1 in the Journal of the American Medical Association, the latest recommendations are presented for the treatment and prevention of HIV, including new antiretroviral therapies and long-acting injectable options.
Rajesh T. Gandhi, M.D., from Massachusetts General Hospital in Boston, and colleagues note that antiretroviral therapy is recommended for all individuals with HIV. Initial regimens composed of an integrase strand transfer inhibitor, specifically bictegravir or dolutegravir, with one or two nucleoside or nucleotide reverse transcriptase inhibitors are recommended for most people with HIV.
Specific recommendations are provided for those with certain clinical circumstances, including pregnancy and active opportunistic diseases. Change of regimen may be necessary for reasons such as virologic failure, adverse effects, convenience, or cost. For those who prefer not to take daily oral medications and those struggling with adherence to therapy, long-acting injectable therapy is available. Recommendations also address laboratory monitoring, management of substance use disorders and weight changes, and statins for prevention of cardiovascular disease. For people with an increased likelihood of HIV exposure, oral (daily or intermittent) and injectable long-acting medications are effective options for HIV prevention. New tools are recommended for maintaining health and well-being among people with HIV, including doxycycline postexposure prophylaxis to avert sexually transmitted infection and strategies to treat substance use disorders.
"Although the tools are available, efforts must be redoubled to reduce disparities and address inequities to realize the promise of ending the HIV epidemic," the authors write.
Several authors disclosed ties to the biopharmaceutical industry.
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