{"id":39043,"date":"2020-10-14T07:39:00","date_gmt":"2020-10-14T07:39:00","guid":{"rendered":"https:\/\/i-base.info\/htb\/?p=39043"},"modified":"2020-10-15T23:05:52","modified_gmt":"2020-10-15T23:05:52","slug":"eacs-guidelines-updated-v-10-1-for-glasgow-conference","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/39043","title":{"rendered":"EACS guidelines updated (v.10.1) for Glasgow conference"},"content":{"rendered":"<div>\n<p class=\"HTBsubhead2articletitle\"><strong><span lang=\"EN-US\"><img loading=\"lazy\" decoding=\"async\" class=\"alignright wp-image-39058\" src=\"https:\/\/i-base.info\/htb\/wp-content\/uploads\/2020\/10\/glasgow-logo-3-291x300.png\" alt=\"\" width=\"199\" height=\"205\" srcset=\"https:\/\/i-base.info\/htb\/wp-content\/uploads\/2020\/10\/glasgow-logo-3-291x300.png 291w, https:\/\/i-base.info\/htb\/wp-content\/uploads\/2020\/10\/glasgow-logo-3.png 333w\" sizes=\"auto, (max-width: 199px) 100vw, 199px\" \/><\/span>Simon Collins, HIV i-Base<\/strong><\/p>\n<\/div>\n<p><strong>The latest update to the EACS HIV guidelines (version 10.1) is now available (English version), with minor updates to all sections.<\/strong><\/p>\n<p>They are available as a free app, an interactive web version and as an online PDF.<\/p>\n<p>A useful five minute YouTube introduction is also online:<br \/>\n<a href=\"https:\/\/www.youtube.com\/watch?v=MwLBoy12cZ0\">https:\/\/www.youtube.com\/watch?v=MwLBoy12cZ0<\/a><\/p>\n<p>The main changes in each section are included below.<\/p>\n<h2>ART section<\/h2>\n<ul>\n<li><span lang=\"EN-US\">First-line combinations are now categorised as &#8216;recommended&#8217;, &#8216;alternative&#8217; and &#8216;other&#8217;.<\/span><\/li>\n<li><span lang=\"EN-US\">Recommended regimens include unboosted INSTI (DTG, BIC or RAL) plus 2 NRTIs or the dual combination 3TC\/DTG (which no longer has a CD4 restriction].<\/span><\/li>\n<li><span lang=\"EN-US\">Dual DRV\/b + DTG is now included as a switch option.<\/span><\/li>\n<li><span lang=\"EN-US\">Recommendations for viral failure is now: \u201cNew regimen will usually use at least one fully active PI\/b (e.g. DRV\/b) plus a drug remaining fully active despite resistance to other drugs from the class (e.g. INSTI, NNRTI) and\/or from a class not used previously (e.g. INSTI, NNRTI, PI, CCR5 antagonist (if tropism test shows R5 virus only) assessed by genotypic testing\u201d.<\/span><\/li>\n<li><span lang=\"EN-US\">TAF is now allowed for women who become pregnant while on ART.<\/span><\/li>\n<li><span lang=\"EN-US\">TAF\/FTC+DTG is now included as a recommended regimen for ART-na\u00efve pregnant women.<\/span><\/li>\n<li><span lang=\"EN-US\">Alternative PEP drugs now include DRV\/b and drop AZT\/3TC.<\/span><\/li>\n<\/ul>\n<h2>Drug-drug interaction (DDI) section<\/h2>\n<p>All tables include changes in the HIV drug interaction website (University of Liverpool).<\/p>\n<ul>\n<li><span lang=\"EN-US\">EFV + atorvastatin: changed to amber due to the decrease in atorvastatin exposure requiring the monitoring of lipid values.<\/span><\/li>\n<li>RPV + chloroquine, methadone or pimozide were changed to amber due to the known risk for QT interval prolongation associated with the comedication.<\/li>\n<li>A note on the risk of DDI with ibalizumab has been added to the footnote of each DDI table.<\/li>\n<li>Ibalizumab has been added in the table for people with swallowing difficulties and the tables for dose adjustment in case of renal and hepatic impairment.<\/li>\n<\/ul>\n<h2>Co-morbidity section and complications<\/h2>\n<div>\n<ul>\n<li class=\"HTBBODYindent\"><span lang=\"EN-US\">Increased risk of neural tube defects associated with DTG.<\/span><\/li>\n<li class=\"HTBBODYindent\">An HIV-specific reference has been included for the PCSK9 inhibitor, evolocumab.<\/li>\n<li class=\"HTBBODYindent\">An indication to intervene if BMI \u2265 30 kg\/m2 or \u2265 25 kg\/m2 and weight-related complications (diabetes mellitus, hypertension) with expanded detail regarding exercise, dietary, behavioural and therapeutic management.<\/li>\n<li class=\"HTBBODYindent\">In sero-discordant couples, fully effective ART should be a primary goal. If not achieved, PrEP can be used if the couple are looking to conceive.<\/li>\n<li class=\"HTBBODYindent\">In PLWH at high risk of STI, three-monthly STI screening is recommended.<\/li>\n<li class=\"HTBBODYindent\">Treatment for gonorrhoea has been updated to single dose ceftriaxone 1g IM.<\/li>\n<\/ul>\n<h2>Viral Hepatitis Co-infections section<\/h2>\n<\/div>\n<div>\n<ul>\n<li class=\"HTBBODYindent\"><span lang=\"EN-US\">Updated tables on HCV treatment and DDIs.<\/span><\/li>\n<li class=\"HTBBODYindent\">Resistance testing guidance before re-treatment with DAAs has been modified.<\/li>\n<li class=\"HTBBODYindent\">No changes in sections on HBV, HDV and HEV.<\/li>\n<\/ul>\n<h2>Opportunistic Infections section<\/h2>\n<\/div>\n<ul>\n<li><span lang=\"EN-US\">Minor stylistic changes were made to all OI tables.\u00a0<\/span><\/li>\n<li><span lang=\"EN-US\">Cidofovir was deleted as secondary prophylaxis\/maintenance therapy for\u00a0CMV.<\/span><\/li>\n<li>Rifabutin was added to the list of drugs for primary prophylaxis of Non-Tuberculosis Mycobacteria.<\/li>\n<li>Moxifloxacin was added to the list of drugs for treatment of MAC.<\/li>\n<\/ul>\n<div>\n<p class=\"HTBBODYtext\">Reference<\/p>\n<\/div>\n<ol>\n<li>EACS Guidelines 2020. (October 2020).<br \/>\n<a href=\"https:\/\/eacs.sanfordguide.com\">https:\/\/eacs.sanfordguide.com<\/a><\/li>\n<li><a href=\"https:\/\/www.eacsociety.org\/guidelines\/eacs-guidelines\/eacs-guidelines.html\">https:\/\/www.eacsociety.org\/guidelines\/eacs-guidelines\/eacs-guidelines.html<\/a><\/li>\n<\/ol>\n<p><em>This report was first published online on 5 October 2020.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Simon Collins, HIV i-Base The latest update to the EACS HIV guidelines (version 10.1) is now available (English version), with minor updates to all sections. They are available as a free app, an interactive web version and as an online &hellip;<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,23],"tags":[299],"class_list":["post-39043","post","type-post","status-publish","format-standard","hentry","category-conference-reports","category-guidelines","tag-glasgow-2020"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/39043","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=39043"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/39043\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=39043"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=39043"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=39043"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}