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Antiretroviral treatment for HIV infection: Swedish recommendations 2019

Jaran Eriksen1,2, Christina Carlander3,4, Jan Albert5,6

  • 1Unit of Infectious Diseases/Venhälsan, Södersjukhuset, Stockholm, Sweden.

Infectious Diseases (London, England)
|January 14, 2020
PubMed

Insights

Updated HIV treatment guidelines confirm zero transmission risk from virally suppressed individuals and recommend Pre-exposure Prophylaxis (PrEP) for high-risk groups. New drugs and dual therapies are also highlighted.

Area of Science:

  • Antiviral Therapy
  • Infectious Disease Management

Background:

  • The Swedish Reference Group for Antiviral Therapy (RAV) previously issued HIV treatment recommendations in 2017.
  • Expert guidance is essential for updating clinical protocols based on evolving scientific evidence.

Purpose of the Study:

  • To provide updated clinical recommendations for the management of HIV infection.
  • To incorporate recent advancements in antiretroviral therapy and HIV prevention strategies.

Main Methods:

  • Evidence-grading of recommendations based on the Oxford Centre for Evidence Based Medicine criteria.
  • Review and synthesis of current scientific literature and clinical trial data.

Main Results:

  • HIV transmission risk is effectively zero from individuals with a fully suppressed viral load during condomless sex.
  • Pre-exposure prophylaxis (PrEP) is recommended for individuals at high risk of HIV acquisition.
  • Introduction of new antiretroviral agents: bictegravir and doravirine.
  • Dual therapy regimens (lamivudine + dolutegravir or lamivudine + boosted darunavir/atazanavir) are viable alternatives for select patients.

Conclusions:

  • Current evidence supports U=U (Undetectable = Untransmittable) for HIV prevention.
  • Expanded PrEP indications enhance public health strategies against HIV.
  • Newer antiretroviral options offer improved efficacy and tolerability in HIV treatment regimens.

Keywords:
AntiretroviralHIVSwedenadultpaediatrictreatment guidelines

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