BHIVA guidelines on antiretroviral treatment for adults living with HIV-1 2022 (2025 interim update)
BHIVA guidelines on antiretroviral treatment for adults living with HIV-1 2022 (2025 interim update) - British HIV Association (BHIVA)
The overall purpose of these guidelines is to provide guidance on best clinical practice for antiretroviral therapy (ART) and management of adults living with human immunodeficiency virus (HIV). The scope includes: (i) guidance on the initiation of ART in those previously naïve to therapy; (ii) support of people living with HIV on treatment; (iii) management of individuals experiencing virological failure; (iv) switch for tolerability and/or toxicity issues; and (v) recommendations for specific populations where other factors need to be taken into consideration. The guidelines are written for clinical professionals directly involved with and responsible for the care of adults living with HIV, community advocates responsible for promoting the best interests and care of adults living with HIV, and people living with HIV for whom non-technical summaries are also be available, if preferred.
In an interim update of the guidelines in 2023, the ‘cardiovascular considerations’ section related to adjusting cardiovascular disease risk estimates for people living with HIV was amended. This change, with the supporting evidence, is highlighted in yellow.
The purpose of the 2025 interim update of the guidelines was to update our recommendations based on new evidence since the last update, including: (i) incorporating new evidence related to injectable therapy including frequency of viral load monitoring and use of long-acting cabotegravir/rilpivirine in non-virally suppressed people; (ii) removal of abacavir from first-line recommendations for most and a recommendation to switch away from abacavir where clinically appropriate; (iii) removal of the CD4 caveat for first-line dolutegravir/lamivudine use; (iv) updated recommendations for people with NRTI resistance. These changes, with the supporting evidence, are highlighted in green.