miargo17 HIV Treatment Regimens CDC Guidelines, AdulAdolescent: HIV Treatment Guidelines per the Centers for Disease Control Medscape HIV Treatment Regimens CDC Guidelines, Adult/Adolescent Updated: Aug 12, 2014 Author: Jason F Okulicz, MD, FACP, FIDSA; more... This site is intended for healthcare professionals HIV Treatment Guidelines per the Centers for Disease Control The Centers for Disease Control (CDC) and other federal government agencies have issued several guidelines and recommendations about the prevention, screening, diagnosis, treatment, and management of HIV infection. !"! The CDC references the most current Department of Health and Human Services (DHHS) guidelines for the use of antiretroviral agents in HIV-1—infected adults and adolescents 1 { [5] summarized below. Initial combination regimens for antiretroviral-naive patients An initial antiretroviral regimen generally consists of two nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs), either tenofovir/emtricitabine (TDF/FTC) or abacavir/lamivudine (ABC/3TC) plus ‘one active drug from one of the following classes: nonnucleoside reverse transcriptase inhibitor (NNRTI), protease inhibitor (PI; boosted with ritonavir [RTV]), or integrase strand transfer inhibitor (INSTI), Selection of a regimen should be individualized based on virologic efficacy, potential adverse effects, pill burden, dosing frequency, drug-drug interaction potential, the patient's resistance test results, ‘comorbid conditions, and cost. Recommended initial antiretroviral therapy (ART) regimen options for all patients, regardless of pre-ART viral load or CD4 cell count See the list below: + NNRTI-based regimen: Efavirenz/ tenofovir! emtricitabine (EFV/TDF/FTC) * Pl-based regimens © Atazanavirlritonavir (ATV/r) + TDF/ETC © Darunaviriritonavir (DRV/r) (once daily) + TOF/FTC + INSTL-based regimens © Raltegravir (RAL) + TDF/FTC © Elvitegravir/cobicistat/tenofovir/emtricitabine (EVG/COBI/TDF/FTC) (only for patients with pretreatment estimated creatinine clearance 270 mL/min) © Dolutegravir (DTG) + ABC/3TC (only for patients who are HLA-B*5701 negative) o DTG + TDF/FTC Other recommended regimens htplemedicine medscape.convatle!2172322-overviow 12miargo17 HIV Treatment Regimens CDC Guidelines, AdulAdolescent: HIV Treatment Guidelines per the Centers for Disease Control In addition to the regimens listed above, the following regimens are also recommended, but only for patients with a pre-ART plasma viral load of less than 100,000 copies/mL. + NNRTI-based regimens © EFV + ABC/3TC (only for patients who are HLA-B*5701 negative) © Rilpivirine/tenofovir/emtricitabine (RPV/TDF/FTC) (only for patients with CD4 count >200 cells/uL) + Pl-based regimen: ATV/r + ABC/3TC (only for patients who are HLA-B*5701 negative) Alternative ini | ART regimen options These are regimens that are effective and tolerable but have potential disadvantages compared with the recommended regimens listed above or have less data from randomized clinical trials. An alternative regimen may be the preferred regimen for some patients. + Pl-based regimens © DRVir + ABC/3TC (only in patients who are HLA-B*5701 negative) © Lopinavirlritonavir (LPV/r) (once or twice daily) + ABC/3TC (only for patients who are HLA- B*5701 negative) © Lopinaviriritonavir (LPV/r) (once or twice daily) + TDF/FTC + INSTL-based regimen: RAL + ABC/3TC (only for patients who are HLA-B*5701 negative) htplemedicine medscape.convatle!2172322-overviow 22