{"id":37068,"date":"2020-01-29T08:30:27","date_gmt":"2020-01-29T08:30:27","guid":{"rendered":"http:\/\/i-base.info\/htb\/?p=37068"},"modified":"2021-02-02T17:30:36","modified_gmt":"2021-02-02T17:30:36","slug":"us-hiv-guidelines-updated-december-2019","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/37068","title":{"rendered":"US HIV Guidelines updated (December 2019)"},"content":{"rendered":"<p class=\"HTBBODYtext\"><b><span lang=\"EN-US\">Simon Collins, HIV i-Base<\/span><\/b><\/p>\n<p class=\"HTBBODYtext\"><b><span lang=\"EN-US\">The latest edition of the US DHSS HIV guidelines is now published online. [1]<\/span><\/b><\/p>\n<p class=\"HTBBODYtext\"><span lang=\"EN-US\">Main changes in this edition are summarised at the start of the main document. [2]<\/span><\/p>\n<p class=\"HTBBODYtext\"><span lang=\"EN-US\">Selected key points are listed below.<\/span><\/p>\n<ul>\n<li class=\"HTBBODYindent\"><span lang=\"EN-US\">Inclusion of a new section on U=U. This stresses that an undetectable viral load &lt;200 copies\/mL with continued high adherence prevents HIV transmission.<\/span><\/li>\n<li class=\"HTBBODYindent\"><span lang=\"EN-US\">Restrictions on use of dolutegravir in relation to neural tube defects during pregnancy have been reduced &#8211; to be decided on individual risk\/benefit.<\/span><\/li>\n<li class=\"HTBBODYindent\"><span lang=\"EN-US\">That random testing for pre-ART lipid and glucose can be used instead of previous recommendation for these to be fasted.<\/span><\/li>\n<li class=\"HTBBODYindent\"><span lang=\"EN-US\">That ART be routinely started either immediately or as soon as possible after diagnosis.<\/span><\/li>\n<li class=\"HTBBODYindent\"><span lang=\"EN-US\">Dolutegravir\/lamivudine dual therapy is added to the list of recommended first-line combinations, unless viral load is &gt;500,000 c\/mL, HBV coinfection or still waiting for genotypic resistance test results or HBV serology.<\/span><\/li>\n<li class=\"HTBBODYindent\"><span lang=\"EN-US\">Bictegravir\/FTC\/TAF is included as a combination for immediate ART if resistance test results are not available.<\/span><\/li>\n<li class=\"HTBBODYindent\"><span lang=\"EN-US\">Updated and expanded section on HIV and older people. This includes awareness of HIV risk, age-related comorbidities, importance of ART, polypharmacy and management of HIV associated neurocognitive disorder (HAND).<\/span><\/li>\n<li class=\"HTBBODYindent\"><span lang=\"EN-US\">Option for short course regimen for latent TB.<\/span><\/li>\n<li class=\"HTBBODYindent\"><span lang=\"EN-US\">A new sub-section on drug pricing and access in the US.<\/span><\/li>\n<li class=\"HTBBODYindent\"><span lang=\"EN-US\">Updated tables on side effects and drug interactions.<\/span><\/li>\n<\/ul>\n<p>References<\/p>\n<ol>\n<li class=\"HTBreference-noindent\"><span lang=\"EN-US\">US Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents with HIV. 18 December 2019.<br \/>\n<a href=\"https:\/\/clinicalinfo.hiv.gov\/en\/guidelines\">https:\/\/clinicalinfo.hiv.gov\/en\/guidelines<\/a><\/span><\/li>\n<li class=\"HTBreference-noindent\"><span lang=\"EN-US\">What\u2019s new in the guidelines.<br \/>\n<\/span><a href=\"https:\/\/aidsinfo.nih.gov\/guidelines\/html\/1\/adult-and-adolescent-arv\/0\" rel=\"noopener noreferrer\">https:\/\/aidsinfo.nih.gov\/guidelines\/html\/1\/adult-and-adolescent-arv\/0<\/a><\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Simon Collins, HIV i-Base The latest edition of the US DHSS HIV guidelines is now published online. [1] Main changes in this edition are summarised at the start of the main document. [2] Selected key points are listed below. Inclusion &hellip;<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[23],"tags":[],"class_list":["post-37068","post","type-post","status-publish","format-standard","hentry","category-guidelines"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/37068","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=37068"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/37068\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=37068"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=37068"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=37068"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}