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HIV Med. 2018 May;19(5):309-315. doi: 10.1111/hiv.12600. Epub 2018 Mar 1.

Highlights of the 2017 European AIDS Clinical Society (EACS) Guidelines for the treatment of adult HIV-positive persons version 9.0.

Author information

1
CHIP, Department of Infectious Diseases, Section 2100, Finsencentret, Rigshospitalet, University Hospital of Copenhagen, University of Copenhagen, Copenhagen, Denmark.
2
Department of Medicine, University of Bonn, Bonn, Germany.
3
HIV/GUM Department, Chelsea and Westminster NHS Foundation Trust, London, UK.
4
Infectious Diseases Service, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain.
5
Chelsea and Westminister Hospital NHS Foundation Trust, London, UK.
6
HIV Unit, Hospital La Paz, Madrid, Spain.
7
Clinic for Immunology and Rheumatology, Medical School Hannover, Hannover, Germany.
8
HIV Molecular Research Group, School of Medicine, University College Dublin, Dublin, Ireland.
9
Department of Infectious Diseases, Hospital Niguerda Ca' Granda, Milan, Italy.
10
Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
11
Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel and University of Basel, Basel, Switzerland.
12
Department of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.

Abstract

BACKGROUND:

The European AIDS Clinical Society (EACS) Guidelines have since 2005 provided multidisciplinary recommendations for the care of HIV-positive persons in geographically diverse areas.

GUIDELINE HIGHLIGHTS:

Major revisions have been made in all sections of the 2017 Guidelines: antiretroviral treatment (ART), comorbidities, coinfections and opportunistic diseases. Newly added are also a summary of the main changes made, and direct video links to the EACS online course on HIV Management. Recommendations on the clinical situations in which tenofovir alafenamide may be considered over tenofovir disoproxil fumarate are provided, and recommendations on which antiretrovirals can be used safely during pregnancy have been revised. Renal and bone toxicity and hepatitis C virus (HCV) treatment have been added as potential reasons for ART switches in fully virologically suppressed individuals, and dolutegravir/rilpivirine has been included as a treatment option. In contrast, dolutegravir monotherapy is not recommended. New recommendations on non-alcoholic fatty liver disease, chronic lung disease, solid organ transplantation, and prescribing in elderly are included, and human papilloma virus (HPV) vaccination recommendations have been expanded. All drug-drug interaction tables have been updated and new tables are included. Treatment options for direct-acting antivirals (DAAs) have been updated and include the latest combinations of sofosbuvir/velpatasvir/voxilaprevir and glecaprevir/pibrentasvir. Recommendations on management of DAA failure and acute HCV infection have been expanded. For treatment of tuberculosis (TB), it is underlined that intermittent treatment is contraindicated, and for resistant TB new data suggest that using a three-drug combination may be as effective as a five-drug regimen, and may reduce treatment duration from 18-24 to 6-10 months.

CONCLUSIONS:

Version 9.0 of the EACS Guidelines provides a holistic approach to HIV care and is translated into the six most commonly spoken languages.

KEYWORDS:

ART; European AIDS Clinical Society guidelines; HBV; HCV; HIV; antiretroviral treatment; coinfections; comorbidities; opportunistic diseases

PMID:
29493093
PMCID:
PMC5947127
DOI:
10.1111/hiv.12600
[Indexed for MEDLINE]
Free PMC Article

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