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

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  • Lene Ryom
  • Rosa De Miguel
  • Aoife Grace Cotter
  • Daria Podlekareva
  • Charles Beguelin
  • Hylke Waalewijn
  • Josè R. Arribas
  • Patrick W. G. Mallon
  • Catia Marzolini
  • Alasdair Bamford
  • Andri Rauch
  • Jean Michel Molina
  • Justyna Dominika Kowalska
  • Giovanni Guaraldi
  • Alan Winston
  • Christoph Boesecke
  • Paola Cinque
  • Steven Welch
  • Simon Collins
  • Georg M.N. Behrens

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.

TidsskriftHIV Medicine
Udgave nummer8
Sider (fra-til)849-858
Antal sider10
StatusUdgivet - 2022

Bibliografisk note

Funding Information:
Declarations of interest of all panel members are available upon request. Please contact . LR, CBe, DP, SC, HW and AB report no conflicts of interest. RDM reports personal fees (speaker fee) and non‐financial support from ViiV and Gilead. JRA reports advisory fees and speaker fees for ViiV, Janssen, Gilead, MSD, Alexa, Theranos and grant support from ViiV. JMM has taken part in advisory boards for Gilead, ViiV and Merck, and received research grant from Gilead. AGC has previously received a research grant to her institution from Gilead Sciences Ltd and previous honoraria from Gilead Sciences, MSD and Janssen Cilag. AW has received research grants, speaker honoraria or advisory fees from Gilead Sciences, ViiV Healthcare, Janssen and MSD. PGMM has received honoraria from Bristol Myers Squibb, Gilead Sciences, Janssen and Merck Sharpe and Dohme. JAR reports support to his institution for advisory boards and/or travel grants from MSD, Gilead Sciences, Pfizer and Abbvie, and an investigator‐initiated trial grant from Gilead Sciences. All remuneration went to his home institution and not to AR personally. CB has received honoraria for consulting or educational lectures from Abbvie, BMS, Gilead, Janssen, MSD and ViiV, and research grants from Dt. Leberstiftung, DZIF, Hector Stiftung and NEAT ID. OK reports personal fees and non‐financial support from Gilead, and personal fees from ViiV, Merck and Janssen. PC reports speaker's bureau from Gilead Sciences and ViiV Healthcare and consultancy work for Johnson & Johnson, Pfizer, Shire, Takeda, Cellevolve, Excision and Exevir, and research support from Gilead Sciences. SW has been part of an advisory board for ViiV with no personal remuneration and have organised training programmes for Penta with financial support from Gilead, ViiV and Janssen, again with no personal financial remuneration. CM has received research funding from Gilead and honoraria for lectures from ViiV and MSD. GG received research supports, honoraria and consultation fees from ViiV, Gilead, Merck and Jansen. JK has been a board member/advisory panel/grant recipient for Gilead Sciences, Glaxo SmithKline, ViiV, Janssen‐Cilag, MSD and Roche. GMNB reports support for advisory boards and/or lectures from MSD, Gilead Sciences, ViiV Healthcare or Janssen. His institution received support for interventional trials in HIV therapy from MSD and ViiV Healthcare. All remunerations were provided outside the submitted work.

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

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