Guidelines

Sub-section: Protease Inhibitor-Based Regimens Summary The Food and Drug Administration (FDA)-approved protease inhibitors (PIs) include atazanavir (ATV), ATV/cobicistat (ATV/c), darunavir (DRV), darunavir/cobicistat (DRV/c), fosamprenavir (FPV), indinavir (IDV), lopinavir/ritonavir (LPV/r), nelfinavir (NFV), ritonavir (RTV), saquinavir (SQV), and tipranavir (TPV). PI-based regimens using pharmacokinetic (PK) enhancement with either cobicistat (COBI) or RTV (also called PK boosting) increase …

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Most currently recommended antiretroviral (ARV) regimens consist of two nucleoside reverse transcriptase inhibitors (NRTIs) plus a third active drug. In some clinical situations, it is preferable to avoid abacavir (ABC), tenofovir alafenamide (TAF), and tenofovir disoproxil fumarate (TDF), such as in patients who are HLA-B*5701 positive or at high risk of cardiovascular disease and with …

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AU Comment: Doravirine and Atazanavir/Ritonavir Australian clinicians should note that neither Atazanavirc o–formulated with ritonavir nor Doravirine are listed on the PBS. Note: All drugs within an ARV class are listed in alphabetical order.

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 …

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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 …

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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 …

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This section has information on laboratory testing. Please click on the below links or follow the table of contents to access the information you are looking for. Tests for Initial Assessment and Follow-Up Drug-Resistance Testing HLA-B* 5701 Screening Plasma HIV-1 RNA (Viral Load) and CD4 Count Monitoring Co-receptor Tropism Assays

AU Comment: IGRA testing Interferon gamma release assays (IGRAs), such as the QuantiFERON-TB Gold assay, detect circulating T cells reactive with antigens of Mycobacterium tuberculosis (M.tb). The tuberculin skin test (TST) also detects M. tuberculosis-reactive T cells but T cells reactive with antigens of BCG and non-tuberculous mycobacteria may also be detected, resulting in a …

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AU Comment: Plasma HIV-1 RNA (Viral Load) and CD4 Count Monitoring Plasma HIV-1 RNA (Viral Load) and CD4 Count Monitoring: Current DHHS guidelines are suitable for implementation in Australia, noting the following principles: Viral load testing Viral load is the most important indicator of initial and sustained response to ART and should be measured in …

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