UK treatment guidelines online (2005)
The 2005 UK Treatment Guidelines are now published online by the British HIV Association (BHIVA).
BHIVA Guidelines are prepared by a writing sub-committee, who jointly take responsibility for the recommendations, which are based on published data and evidence-based medicine.
This is a major revision to the guidelines that were last updated in 2003.
Some of the main changes include:
- Broadening access to HIV testing, and encouraging less reliance on GUM/STI clinic setting for routine and low-risk testing.
- The section on methodology has been extensively updated. Additional information includes new discussion of definition of viral load endpoints, including an explanation of the time to loss of virologic response (TLOVR) algorithm, and a section on issues surrounding non-inferiority trials.
- Adherence interventions should be a routine part of clinic care, provided by all healthcare professionals rather than the responsibility of specialist workers. Treatment simplification should not be at the expense of clinical efficacy.
- A new section is included that reviews the data on gender and treatment, and highlights the increasing ethnic diversity of the UK HIV positive population which has particular implications for access to and uptake of care.
- A new section discusses the choice of background nucleosides for first-line treatment, preferring either tenofovir/FTC or abacavir/3TC, and highlighting caution for lipoatrophy for patients currently using ATZ/3TC.
- The sections on resistance testing and TDM have both been expanded
- A new section is included on cost-benefit analysis of antiretrovirals
- The section on management of lipodystrophy and lipid disorders has been updated and revised, including a discussion and recommendations for corrective procedures, including New-Fill and Bio-Alcamid, and an algorithm for patient management.
The Guidelines were published in the July supplement of HIV Medicine and available to download as a Word or pdf file from the BHIVA website.