WHO Releases Updated Recommendations on HIV Clinical Management

Living with HIV today is very different from what it was a decade ago. Treatments are more effective, side effects are fewer, and people are living longer, healthier lives. Nevertheless, staying updated with the latest medical guidelines is crucial for both patients and healthcare providers.

In support of this, the World Health Organization (WHO) has released updated recommendations on HIV clinical management. These updates focus on improving treatment outcomes, reducing HIV-related deaths, and moving closer to ending AIDS as a public health threat.

Why These New Recommendations Matter?

HIV care continues to evolve. Since the WHO last released consolidated HIV guidelines in 2021, new evidence has emerged on improved treatment options and simpler ways to prevent complications.

The updated guidance reflects these advances. It aims to make HIV treatment more effective, easier to follow, and more accessible, particularly in real-world clinical settings. For people living with HIV, this means care that supports long-term health and fits into their daily lives.

Updates in Antiretroviral Therapy

Antiretroviral therapy remains the foundation of HIV care. WHO’s updated recommendations confirm that dolutegravir-based regimens continue to be the preferred choice for both starting treatment and for ongoing therapy.

For people whose current treatment is no longer working, WHO has introduced important changes. When a protease inhibitor is required, darunavir combined with ritonavir is now recommended as the preferred option. This replaces earlier regimens that were more commonly used in the past.

The guideline also supports reusing medications such as tenofovir and abacavir in later treatment regimens when appropriate. This approach is based on improved outcomes, practical advantages, and potential cost savings, without compromising effectiveness.

New Options for People Who Struggle with Daily Pills

For some people, taking medication every day is a challenge. The WHO has now acknowledged this reality more explicitly.

In specific circumstances, particularly for adults and adolescents who find it difficult to adhere to daily oral treatment, the updated recommendations support the use of long-acting injectable antiretroviral therapy.

For selected, clinically stable individuals, simplified oral two-drug regimens are also recommended. These options can reduce the pill burden while maintaining good viral control, helping people to remain consistent with their treatment over time.

Preventing HIV Transmission from Mother to Child

Significant progress has been achieved in preventing vertical HIV transmission. However, new infant infections still occur, particularly during breastfeeding.

The WHO's updated guidance emphasizes a person-centered approach that respects maternal choice while prioritizing infant health. Mothers living with HIV are encouraged to exclusively breastfeed for the first six months, continue breastfeeding up to 12 months, and in some cases for longer, alongside effective antiretroviral therapy.

All infants exposed to HIV should receive six weeks of postnatal prophylaxis, preferably with nevirapine. Infants at higher risk may require enhanced triple-drug prophylaxis. In some cases, extended prophylaxis may continue until the mother's viral load is fully suppressed or until breastfeeding ceases. These measures aim to protect infants while supporting safe and informed feeding choices.

Strengthening TB Prevention in People Living with HIV

Tuberculosis is one of the leading causes of death among people living with HIV. Therefore, preventing TB is a crucial part of HIV care.

To improve the completion and uptake of preventive treatment, the WHO now recommends the three-month, once-weekly isoniazid plus rifapentine (3HP) regimen as a preferred option for adults and adolescents living with HIV.

Shorter and simpler regimens make it easier for patients to complete treatment. They also help health systems integrate TB prevention more seamlessly into routine HIV care, thereby reducing TB-related illness and death.

What does this mean for Patients and Families?

For people living with HIV, these updates support care that is simpler, more effective, and tailored to real-life needs. Improved treatment options mean better viral control, fewer complications, and a better quality of life.

For families, especially mothers and infants, the guidelines provide clear pathways to reduce transmission risks while supporting healthy growth and development. Progress in HIV care is not just about medications; it's about supporting long-term well-being.

Source

Updated recommendations on HIV clinical management