ARV Guidelines

Summary Five NNRTIs—delavirdine (DLV), doravirine (DOR), efavirenz (EFV), etravirine (ETR), nevirapine (NVP), and rilpivirine (RPV) are currently approved by the Food and Drug Administration (FDA) for the treatment of HIV when used in combination with other antiretroviral (ARV) drugs. This section of the guidelines will focus on DOR, EFV, and RPV, the three NNRTIs recommended …

Non-Nucleoside Reverse Transcriptase Inhibitor-Based Regimens Read More »

Summary Four integrase strand transfer inhibitors (INSTIs)—bictegravir (BIC), dolutegravir (DTG), elvitegravir (EVG), and raltegravir (RAL)—are approved for use in antiretroviral therapy (ART)-naive patients with HIV. Cabotegravir (CAB) is a new INSTI that is approved to be used with rilpivirine (RPV) as part of a long-acting injectable complete antiretroviral (ARV) regimen to replace a stable oral …

Integrase Strand Transfer Inhibitor–Based Regimens Read More »

AU comment: Doravirine The non-nucleoside reverse transcriptase inhibitor doravirine (DOR), was approved by the TGA in 2020 as a single drug or as a fixed dose combination with TDF and lamivudine (3TC). DOR/TDF/3TC is NOT reimbursed under the PBS in Australia. Summary The Food and Drug Administration (FDA)-approved nucleos(t)ide reverse transcriptase inhibitors (NRTIs) include zidovudine …

Nucleoside Reverse Transcriptase Inhibitor Read More »

AU comment: CAB-LA in Australia Long-acting cabotegravir (CAB-LA) for PrEP was TGA approved in 2022 but is not reimbursed under the PBS or commonly used as PrEP in Australia. However, individuals may have accessed CAB-LA as PrEP while overseas. Clinicians should ensure that integrase genotypic resistance testing is requested to exclude integrase strand transfer inhibitor …

Selecting an ART regimen Read More »

AU Comment: CAB-LA in Australia Long-acting cabotegravir (CAB-LA) for PrEP was TGA approved in 2022 but is not reimbursed under the PBS or commonly used as PrEP in Australia. However, individuals may have accessed CAB-LA as PrEP while overseas. Clinicians should ensure that integrase genotypic resistance testing is requested to exclude integrase strand transfer inhibitor …

Initial Combination ARV Regimens for People with HIV Read More »

This section has information on What to Start. Please click on the below links or follow the table of contents to access the information you are looking for. Initial Combination ARV Regimens for People with HIV Nucleoside Reverse Transcriptase Inhibitor Non-Nucleoside Reverse Transcriptase Inhibitor-Based Regimens Other ARV Regimens ARV Components or Regimens Not Recommended as …

What to Start Read More »

AU Comment: ART to prevent sexual transmission of HIV in the Australian context This guidance should be read in conjunction with ASHM’s U=U Guidance for Healthcare professionals, which defines an undetectable viral load as:  two consecutive undetectable viral load test results separated by at least four weeks; or, more conservatively, a full 6-month period during …

Antiretroviral Therapy to Prevent Sexual Transmission of HIV Read More »

Panel’s Recommendations Antiretroviral therapy (ART) is recommended for all persons with HIV to reduce morbidity and mortality (AI) and to prevent the transmission of HIV to others (AI). The Panel on Antiretroviral Guidelines for Adults and Adolescents recommends initiating ART immediately (or as soon as possible) after HIV diagnosis in order to increase the uptake of ART and …

Initiation of Antiretroviral Therapy Read More »

AU Comment: Treatment goals in Australia The principles of treatment goals of ART in Australia are consistent with DHHS recommendations, noting that in Australia both two and three drug ARV regimens are available. Antiretroviral therapy (ART) has reduced HIV-related morbidity and mortality at all stages of HIV infection1-4 and has reduced HIV transmission.5-8 Maximal and durable suppression …

Treatment Goals Read More »

AU Comment: HLA-B*5701 screening: DHHS recommendations are suitable for implementation in Australia, including: Screening for HLA-B*5701 before starting patients on an abacavir (ABC)-containing regimen to reduce the risk of hypersensitivity reaction (HSR) (AI). Avoidance of ABC- in HLA-B*5701-positive patients and documentation of HLA-B*5701-positive status as an ABC allergy in the patient’s medical record, noting the risk …

HLA-B* 5701 Screening Read More »