TY - JOUR

T1 - Major revision version 11.0 of the European AIDS Clinical Society Guidelines 2021

AU - Ryom, Lene

AU - De Miguel, Rosa

AU - Cotter, Aoife Grace

AU - Podlekareva, Daria

AU - Beguelin, Charles

AU - Waalewijn, Hylke

AU - Arribas, Josè R.

AU - Mallon, Patrick W. G.

AU - Marzolini, Catia

AU - Kirk, Ole

AU - Bamford, Alasdair

AU - Rauch, Andri

AU - Molina, Jean Michel

AU - Kowalska, Justyna Dominika

AU - Guaraldi, Giovanni

AU - Winston, Alan

AU - Boesecke, Christoph

AU - Cinque, Paola

AU - Welch, Steven

AU - Collins, Simon

AU - Behrens, Georg M.N.

N1 - Publisher Copyright: © 2022 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association.

PY - 2022

Y1 - 2022

N2 - Background: The European AIDS Clinical Society (EACS) Guidelines were revised in 2021 for the 17th time with updates on all aspects of HIV care. Key points of the Guidelines update: Version 11.0 of the Guidelines recommend six first-line treatment options for antiretroviral treatment (ART)-naïve adults: tenofovir-based backbone plus an unboosted integrase inhibitor or plus doravirine; abacavir/lamivudine plus dolutegravir; or dual therapy with lamivudine or emtricitabine plus dolutegravir. Recommendations on preferred and alternative first-line combinations from birth to adolescence were included in the new paediatric section made with Penta. Long-acting cabotegravir plus rilpivirine was included as a switch option and, along with fostemsavir, was added to all drug–drug interaction (DDI) tables. Four new DDI tables for anti-tuberculosis drugs, anxiolytics, hormone replacement therapy and COVID-19 therapies were introduced, as well as guidance on screening and management of anxiety disorders, transgender health, sexual health for women and menopause. The sections on frailty, obesity and cancer were expanded, and recommendations for the management of people with diabetes and cardiovascular disease risk were revised extensively. Treatment of recently acquired hepatitis C is recommended with ongoing risk behaviour to reduce transmission. Bulevirtide was included as a treatment option for the hepatitis Delta virus. Drug-resistant tuberculosis guidance was adjusted in accordance with the 2020 World Health Organization recommendations. Finally, there is new guidance on COVID-19 management with a focus on continuance of HIV care. Conclusions: In 2021, the EACS Guidelines were updated extensively and broadened to include new sections. The recommendations are available as a free app, in interactive web format and as an online pdf.

AB - Background: The European AIDS Clinical Society (EACS) Guidelines were revised in 2021 for the 17th time with updates on all aspects of HIV care. Key points of the Guidelines update: Version 11.0 of the Guidelines recommend six first-line treatment options for antiretroviral treatment (ART)-naïve adults: tenofovir-based backbone plus an unboosted integrase inhibitor or plus doravirine; abacavir/lamivudine plus dolutegravir; or dual therapy with lamivudine or emtricitabine plus dolutegravir. Recommendations on preferred and alternative first-line combinations from birth to adolescence were included in the new paediatric section made with Penta. Long-acting cabotegravir plus rilpivirine was included as a switch option and, along with fostemsavir, was added to all drug–drug interaction (DDI) tables. Four new DDI tables for anti-tuberculosis drugs, anxiolytics, hormone replacement therapy and COVID-19 therapies were introduced, as well as guidance on screening and management of anxiety disorders, transgender health, sexual health for women and menopause. The sections on frailty, obesity and cancer were expanded, and recommendations for the management of people with diabetes and cardiovascular disease risk were revised extensively. Treatment of recently acquired hepatitis C is recommended with ongoing risk behaviour to reduce transmission. Bulevirtide was included as a treatment option for the hepatitis Delta virus. Drug-resistant tuberculosis guidance was adjusted in accordance with the 2020 World Health Organization recommendations. Finally, there is new guidance on COVID-19 management with a focus on continuance of HIV care. Conclusions: In 2021, the EACS Guidelines were updated extensively and broadened to include new sections. The recommendations are available as a free app, in interactive web format and as an online pdf.

KW - antiretroviral treatment

KW - children

KW - comorbidities

KW - COVID-19

KW - drug–drug interactions

KW - European AIDS Clinical Society (EACS) Guidelines

KW - hepatitis B virus

KW - hepatitis C virus

KW - HIV

KW - opportunistic infections

KW - Penta

U2 - 10.1111/hiv.13268

DO - 10.1111/hiv.13268

M3 - Journal article

C2 - 35338549

AN - SCOPUS:85133521563

VL - 23

SP - 849

EP - 858

JO - HIV Medicine

JF - HIV Medicine

SN - 1464-2662

IS - 8

ER -