What are the European AIDS Clinical Society guidelines on antiretroviral (ART) therapy and chronic HIV infection?

Updated: Jul 01, 2019
  • Author: Nicholas John Bennett, MBBCh, PhD, MA(Cantab), FAAP; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Antiretroviral therapy (ART) is recommended in all adults with chronic HIV infection, irrespective of CD4 counts.

Human papillomavirus (HPV) vaccination is now recommended for all HIV-positive persons up to 26 years of age and up to 40 years of age for men who have sex with men (MSM).

All HIV-positive women of reproductive age should have a pregnancy test.

Screen for sexually transmitted infections (STIs) not only for those at risk, but also during pregnancy.

Pre-exposure prophylaxis (PrEP) should be used in adults at high risk of acquiring HIV infection when condoms are not used consistently.

Before PrEP is initiated, HBV serology status should be documented.

Intermittent tuberculosis (TB) regimens (2 or 3 times per week) are contraindicated in HIV-positive persons.

PrEP is recommended in HIV-negative MSM and transgender individuals when condoms are not used consistently with casual partners or with HIV-positive partners who are not on treatment. A recent STI, use of post-exposure prophylaxis, or chemsex may be markers of increased risk for HIV acquisition.

PrEP may be considered in HIV-negative heterosexual women and men who are inconsistent in their use of condoms and have multiple sexual partners, some of whom are likely to have HIV infection and not being on treatment.

Documented negative fourth-generation HIV test is recommended prior to starting PrEP. During PrEP, this test should be repeated every 3 months, and PrEP should be stopped immediately in case of early clinical signs of HIV seroconversion or a positive HIV diagnostic test and the person referred for evaluation to an HIV unit.


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