Overview

These guidelines provide guidance on the diagnosis of human immunodeficiency virus (HIV) infection, the use of antiretroviral (ARV) drugs for treating and preventing HIV infection and the care of people living with HIV. They are structured along the continuum of HIV testing, prevention, treatment and care.

This edition updates the 2013 consolidated guidelines on the use of antiretroviral drugs following an extensive review of evidence and consultations in mid-2015, shared at the end of 2015, and now published in full in 2016. It is being published in a changing global context for HIV and for health more broadly.

Contents

• FOREWORD
• ABBREVIATIONS AND ACRONYMS
• DEFINITION OF KEY TERMS
• ACKNOWLEDGEMENTS
• EXECUTIVE SUMMARY
• SUMMARY OF RECOMMENDATIONS
• 1. INTRODUCTION
  • 1.1 Context
  • 1.2 Objectives
  • 1.3 Target audience
  • 1.4 Guiding principles
  • 1.5 Methods for developing the guidelines
  • 1.6 Organization of the guidelines
  • References
• 2. CLINICAL GUIDELINES: HIV DIAGNOSIS
  • 2.1 Introduction
  • 2.2 Retesting prior to enrolment in care
  • 2.3 Pre- and post-test services
  • 2.4 Principles of and approaches to service delivery
  • 2.5 HIV diagnosis in infants and children
  • 2.6 Other priority populations
  • 2.7 Diagnostics
  • References
• 3. CLINICAL GUIDELINES: ANTIRETROVIRAL DRUGS FOR HIV PREVENTION
  • 3.1 Oral pre-exposure prophylaxis for preventing the acquisition of HIV
  • 3.2 Post-exposure prophylaxis
  • 3.3 Combination HIV prevention
  • References
• 4. CLINICAL GUIDELINES: ANTIRETROVIRAL THERAPY
  • 4.1 Preparing people living with HIV for ART
  • 4.2 What to expect in the first months of ART
  • 4.3 When to start ART
  • 4.4 What to start: first-line ART
  • 4.5 Monitoring the response to ART and diagnosing treatment failure
  • 4.6 Monitoring of and substitutions for ARV drug toxicities
  • 4.7 Key ARV drug interactions
  • 4.8 What ART regimen to switch to (second- and third-line ART)
  • References
• 5. CLINICAL GUIDELINES: MANAGING COMMON COINFECTIONS AND COMORBIDITIES
  • 5.1 Introduction
  • 5.2 Prevention, screening and management of common coinfections
  • 5.3 Prevention, screening and management of other comorbidities and chronic care for people living with HIV
  • References
• 6. SERVICE DELIVERY
  • 6.1 Introduction
  • 6.2 Differentiated care
  • 6.3 Models of community ARV delivery
  • 6.4 Linkage from HIV testing to enrolment in care
  • 6.5 Retention in care
  • 6.6 Adherence
  • 6.7 Frequency of clinical visits and medication pick-up
  • 6.8 Task shifting and task sharing
  • 6.9 Decentralization
  • 6.10 Integrating and linking services
  • 6.11 Delivering HIV services to adolescents
  • 6.12 Improving the quality of HIV care services
  • 6.13 Procurement and supply management systems for HIV health products
  • 6.14 Laboratory and diagnostic services
  • References
• 7. MONITORING AND EVALUATION
  • 7.1 Introduction
  • 7.2 Selection of indicators
  • 7.3 Data collection and disaggregation
  • 7.4 Reviewing and strengthening monitoring and evaluation systems
  • 7.5 Evaluation, including impact and programme performance
  • 7.6 Other key monitoring considerations
  • References
• 8. PUBLICATION, DISSEMINATION AND EVALUATION
  • 8.1 Publication
  • 8.2 Dissemination and implementation
  • 8.3 Useful tools for planning
  • 8.4 Evaluation
  • References
• ANNEXES
  • ANNEX 1 Declaration of interests, Clinical Guideline Development Group, June 2015
  • ANNEX 2 Declaration of interests, Operational Guideline Development Group, June 2015
  • ANNEX 3 Declaration of interests, external contributors to the systematic reviews
  • ANNEX 4 Declaration of interests, Core Group
  • ANNEX 5 Declaration of interests, Expert Review Group
  • ANNEX 6 Testing strategy for HIV diagnosis in high-prevalence settings
  • ANNEX 7 Testing strategy for HIV diagnosis in low-prevalence settings
  • ANNEX 8 Testing strategy for early infant diagnosis
  • ANNEX 9 Readiness assessment checklist: moving towards ART for pregnant and breastfeeding women
  • ANNEX 10 WHO clinical staging of HIV disease in adults, adolescents and children
  • ANNEX 11 Doses of recommended antiretroviral drugs
  • ANNEX 12 Viral load testing strategy
  • ANNEX 13 Key drug–drug interactions for antiretroviral drugs
  • ANNEX 14 Algorithm for managing people living with HIV who are suspected of having TB (ambulatory)
  • ANNEX 15 Algorithm for managing people living with HIV and suspected of having TB (seriously ill)
  • ANNEX 16 Checklist for periodic evaluation of TB infection control in health facilities
  • ANNEX 17 Checklists for decision-making and implementation
  • ANNEX 18 Models for and country case studies of phased implementation of policies
• SUPPLEMENTARY MATERIAL

This Guidelines contains content that was previously published in the following two documents:

“Guideline on when to start antiretroviral therapy and on pre-exposure prophylaxis for HIV: Early Release” Published in September 2015

“Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: what's new” Policy brief - Published in November 2015; disseminated in December 2015.

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