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Antiretroviral Drugs for Treatment and Prevention of HIV Infection in Adults: 2020 Recommendations of the International Antiviral Society-USA Panel.
Saag, Michael S; Gandhi, Rajesh T; Hoy, Jennifer F; Landovitz, Raphael J; Thompson, Melanie A; Sax, Paul E; Smith, Davey M; Benson, Constance A; Buchbinder, Susan P; Del Rio, Carlos; Eron, Joseph J; Fätkenheuer, Gerd; Günthard, Huldrych F; Molina, Jean-Michel; Jacobsen, Donna M; Volberding, Paul A.
  • Saag MS; University of Alabama at Birmingham.
  • Gandhi RT; Harvard Medical School and Massachusetts General Hospital, Boston.
  • Hoy JF; Monash University and Alfred Hospital, Melbourne, Australia.
  • Landovitz RJ; University of California, Los Angeles.
  • Thompson MA; AIDS Research Consortium of Atlanta, Atlanta, Georgia.
  • Sax PE; Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts.
  • Smith DM; University of California, San Diego, La Jolla.
  • Benson CA; University of California, San Diego, La Jolla.
  • Buchbinder SP; San Francisco Department of Public Health and University of California, San Francisco.
  • Del Rio C; Emory University School of Medicine, Atlanta, Georgia.
  • Eron JJ; School of Medicine, University of North Carolina, Chapel Hill.
  • Fätkenheuer G; University Hospital Cologne, Cologne, Germany.
  • Günthard HF; University Hospital Zurich and Institute of Medical Virology, University of Zurich, Zurich, Switzerland.
  • Molina JM; University of Paris and Saint-Louis/Lariboisière Hospitals, APHP, Paris, France.
  • Jacobsen DM; International Antiviral Society-USA, San Francisco, California.
  • Volberding PA; University of California, San Francisco.
JAMA ; 324(16): 1651-1669, 2020 10 27.
Article in English | MEDLINE | ID: covidwho-865967
Semantic information from SemMedBD (by NLM)
1. HIV Infections PROCESS_OF Adult
Subject
HIV Infections
Predicate
PROCESS_OF
Object
Adult
2. New medications PREVENTS HIV Infections
Subject
New medications
Predicate
PREVENTS
Object
HIV Infections
3. HIV PROCESS_OF Older people
Subject
HIV
Predicate
PROCESS_OF
Object
Older people
4. HIV therapy PREVENTS HIV Infections
Subject
HIV therapy
Predicate
PREVENTS
Object
HIV Infections
5. Viremia PROCESS_OF Persons
Subject
Viremia
Predicate
PROCESS_OF
Object
Persons
6. HIV PROCESS_OF Persons
Subject
HIV
Predicate
PROCESS_OF
Object
Persons
7. Problem PROCESS_OF Patients
Subject
Problem
Predicate
PROCESS_OF
Object
Patients
8. Disease PROCESS_OF Patients
Subject
Disease
Predicate
PROCESS_OF
Object
Patients
9. Treatment Protocols USES Anti-Retroviral Agents
Subject
Treatment Protocols
Predicate
USES
Object
Anti-Retroviral Agents
10. Human body USES regulatory
Subject
Human body
Predicate
USES
Object
regulatory
11. HIV Infections PROCESS_OF Adult
Subject
HIV Infections
Predicate
PROCESS_OF
Object
Adult
12. New medications PREVENTS HIV Infections
Subject
New medications
Predicate
PREVENTS
Object
HIV Infections
13. HIV PROCESS_OF Older people
Subject
HIV
Predicate
PROCESS_OF
Object
Older people
14. HIV therapy PREVENTS HIV Infections
Subject
HIV therapy
Predicate
PREVENTS
Object
HIV Infections
15. Viremia PROCESS_OF Persons
Subject
Viremia
Predicate
PROCESS_OF
Object
Persons
16. HIV PROCESS_OF Persons
Subject
HIV
Predicate
PROCESS_OF
Object
Persons
17. Problem PROCESS_OF Patients
Subject
Problem
Predicate
PROCESS_OF
Object
Patients
18. Disease PROCESS_OF Patients
Subject
Disease
Predicate
PROCESS_OF
Object
Patients
19. Treatment Protocols USES Anti-Retroviral Agents
Subject
Treatment Protocols
Predicate
USES
Object
Anti-Retroviral Agents
20. Human body USES regulatory
Subject
Human body
Predicate
USES
Object
regulatory
ABSTRACT
Importance Data on the use of antiretroviral drugs, including new drugs and formulations, for the treatment and prevention of HIV infection continue to guide optimal practices.

Objective:

To evaluate new data and incorporate them into current recommendations for initiating HIV therapy, monitoring individuals starting on therapy, changing regimens, preventing HIV infection for those at risk, and special considerations for older people with HIV. Evidence Review New evidence was collected since the previous International Antiviral (formerly AIDS) Society-USA recommendations in 2018, including data published or presented at peer-reviewed scientific conferences through August 22, 2020. A volunteer panel of 15 experts in HIV research and patient care considered these data and updated previous recommendations.

Findings:

From 5316 citations about antiretroviral drugs identified, 549 were included to form the evidence basis for these recommendations. Antiretroviral therapy is recommended as soon as possible for all individuals with HIV who have detectable viremia. Most patients can start with a 3-drug regimen or now a 2-drug regimen, which includes an integrase strand transfer inhibitor. Effective options are available for patients who may be pregnant, those who have specific clinical conditions, such as kidney, liver, or cardiovascular disease, those who have opportunistic diseases, or those who have health care access issues. Recommended for the first time, a long-acting antiretroviral regimen injected once every 4 weeks for treatment or every 8 weeks pending approval by regulatory bodies and availability. For individuals at risk for HIV, preexposure prophylaxis with an oral regimen is recommended or, pending approval by regulatory bodies and availability, with a long-acting injection given every 8 weeks. Monitoring before and during therapy for effectiveness and safety is recommended. Switching therapy for virological failure is relatively rare at this time, and the recommendations for switching therapies for convenience and for other reasons are included. With the survival benefits provided by therapy, recommendations are made for older individuals with HIV. The current coronavirus disease 2019 pandemic poses particular challenges for HIV research, care, and efforts to end the HIV epidemic. Conclusion and Relevance Advances in HIV prevention and management with antiretroviral drugs continue to improve clinical care and outcomes among individuals at risk for and with HIV.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: HIV Infections / Anti-Retroviral Agents Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Female / Humans / Male / Pregnancy Country/Region as subject: North America Language: English Journal: JAMA Year: 2020 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: HIV Infections / Anti-Retroviral Agents Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Female / Humans / Male / Pregnancy Country/Region as subject: North America Language: English Journal: JAMA Year: 2020 Document Type: Article