Adult Antiretroviral Guidelines

US DHHS Guidelines with Australian Commentary

Guidelines

CCR5 Antagonist Drug Interactions

Table 24e. Drug Interactions Between the CCR5 Antagonist Maraviroc and Other Drugs (Including Antiretroviral Agents) In the table below, “no dose adjustment needed” indicates that the U.S. Food and Drug Administration– approved dose of maraviroc (MVC) 300 mg twice daily should be used. Recommendations for managing a particular drug interaction may differ, depending on whether …

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Capsid Inhibitor Drug Interactions

Table 24g. Drug Interactions Between the Capsid Inhibitor Lenacapavir and Other Drugs (Including Antiretroviral Drugs) This table provides information on the known or predicted interactions between lenacapavir (LEN), an HIV capsid inhibitor, and other drugs, including antiretroviral (ARV) drugs. LEN is available as an oral tablet (to be used only as initial therapy) and a …

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HIV-1 gp120-Directed Attachment Inhibitors

Table 24f. Drug Interactions Between HIV-1 gp120-Directed Attachment Inhibitors and Other Drugs (Including Antiretroviral Agents) Fostemsavir (FTR), an HIV-1 gp120-directed attachment inhibitor, is a prodrug of temsavir (TMR). In this table, the effect on gp120-directed attachment inhibitor refers to TMR concentrations. Recommendations for managing a particular drug interaction may differ depending on whether a new …

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Interactions between PIs and NNRTIs

Note: Interactions associated with u nboosted atazanavir (ATV), delavirdine (DLV), fosamprenavir (FPV), indinavir (IDV), lopinavir (LPV), nelfinavir (NFV), nevirapine (NVP), saquinavir (SQV), and tipranavir (TPV) are not included in this table. Please refer to the U.S. Food and Drug Administration product labels for information regarding interactions between these drugs and other concomitant drugs. Rilpivirine (RPV) …

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Interactions between INSTI & NNRTI or PI

AU Comment: INSTI and NNRTI regimen switches NSTI metabolism via CYP3A4, concurrent use with inducers results in diminished INSTI plasma concentration – advise caution when switching from NNRTI-based to INSTI-based ART regimens due to NNRTI half-life and resolution of induction effect  AU Comment: Etravirine and cobicistat boosted Integrase regimens Etravirine (ETR) is not recommended in …

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Limitations to Treatment Safety & Efficacy

This section has information on Limitations to Treatment Safety & Efficacy. Please click on the below links or follow the table of contents to access the information you are looking for. Cost Considerations and ART Adherence to the Continuum of Care Adverse Effects of ARV Agents

Adherence to the Continuum of Care

AU Comment: Australian data on rates of virological suppression The 2024 HIV Annual Surveillance Report states there were an estimated 30, 010 people living with HIV in Australia at the end of 2023. Of those, an estimated 92% (27 650) had received an HIV diagnosis. Of those diagnosed, 97% (26,740) were retained in care and …

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Adverse Effects of ARV Agents

AU Comment: Weight gain and INSTIs Several reports have identified associations between the use of integrase strand transfer inhibitors (INSTIs) and increased weight and/or body mass index (BMI). It is unclear if this is a causal relationship or is associated with increased morbidity from conditions typically associated with increased weight such as type 2 diabetes …

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Cost Considerations and ART

AU Comment: ART access in Australia The PBS facilitates affordable access to ART, significantly mitigating out-of-pocket costs for patients with Medicare. For example, a concessional PBS co-payment caps prescription costs AUD $7.30 per script (2025). Non-concessional patients pay up to AUD $30.00. Accredited s100 prescribers in the community can assist patients in navigating these subsidies …

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