What are the DHHS ART Guidelines on antiretroviral therapy for HIV infection in treatment naïve patients?

Updated: Apr 18, 2019
  • Author: R Chris Rathbun, PharmD, BCPS (AQ-ID), AAHIVP; Chief Editor: John Bartlett, MD  more...
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Answer

Currently, 27 antiretroviral agents in 6 antiretroviral classes, including one monoclonal antibody and a myriad of fixed dose combination products, are approved for use in the U.S.. These agents vary in their antiviral potency and administration requirements. It is currently recommended that antiretroviral therapy be initiated with a combination of 3 active antiretrovirals.  The initial combination is generally composed of 2 NRTIs with an NNRTI, PI, or INSTI. [8]

In an attempt to simplify the selection of an initial regimen for treatment-naive patients, the DHHS ART Guidelines have broken down treatment options into 2 main categories:  i) regimens recommended for most people with HIV and ii) other regimens recommended in certain clinical situations.  All of the recommended regimens for most people include 2 NRTIs in combination with an INSTI. All of these recommended regimens have an evidence rating of AI (i.e., strong recommendation with data from randomized controlled trials). These recommendations are based on efficacy and safety of these combinations, as well as other factors, including ease of administration. [8]


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