Diretriz

WHO updated recommendations on HIV clinical management: recommendations for a public health approach

Ano de publicação

2025

Instituição emissora

World Health Organization

Links

Recomendações

16 recomendações incluídas

Use of darunavir/ritonavir and other protease inhibitors in HIV treatment. Darunavir/ritonavir (DRV/r) is the preferred boosted protease inhibitor option for antiretroviral treatment.

Status

Atualizada

Recomendado a favor

Forte

Certeza da evidência

Moderada

Use of darunavir/ritonavir and other protease inhibitors in HIV treatment. Atazanavir/ritonavir (ATV/r) or lopinavir/ritonavir (LPV/r) can be used as an alternative boosted protease inhibitor for antiretroviral treatment

Status

Atualizada

Recomendado a favor

Condicional

Certeza da evidência

Moderada

Use of tenofovir and abacavir for initial and subsequent regimens in HIV treatment. Tenofovir disoproxil fumarate (TDF) or tenofovir alafenamide (TAF) + lamivudine (3TC) or emtricitabine (FTC) is the preferred nucleoside reverse transcriptase inhibitor (NRTI) backbone for initial and subsequent ART in adults, adolescents and children > 30 kg. This includes individuals previously treated with or exposed to tenofovir or zidovudine (AZT).

Status

Atualizada

Recomendado a favor

Forte

Certeza da evidência

Moderada

Use of tenofovir and abacavir for initial and subsequent regimens in HIV treatment. Abacavir (ABC) or tenofovir alafenamide (TAF) + lamivudine (3TC) or emtricitabine (FTC) is the suggested nucleoside reverse transcriptase inhibitor (NRTI) backbone for subsequent ART in children < 30 kg. This includes children previously treated with ABC or zidovudine (AZT)

Status

Atualizada

Recomendado a favor

Condicional

Use of oral two-drug antiretroviral regimens in HIV treatment. Dolutegravir + lamivudine (DTG+3TC) can be used for treatment simplification in adults and adolescents, with undetectable HIV viral load on 3-drug ARV regimens and without active hepatitis B infection.

Status

Nova

Recomendado a favor

Condicional

Certeza da evidência

Moderada

Use of long-acting injectable antiretroviral regimens in HIV treatment. Long-acting injectable cabotegravir + rilpivirine (CAB+RPV) can be used as an alternative switching option in adults and adolescents who have an undetectable HIV viral load on oral ART and no active hepatitis B infection.

Status

Nova

Recomendado a favor

Condicional

Certeza da evidência

Moderada

Infant postnatal prophylaxis. Infants who are not at high risk of acquiring HIV should receive six weeks of infant prophylaxis with a single drug, with nevirapine (NVP) as the preferred option.

Status

Atualizada

Recomendado a favor

Forte

Certeza da evidência

Moderada

Infant postnatal prophylaxis. Infants who are not at high risk of acquiring HIV should receive six weeks of infant prophylaxis with a single drug. DTG or 3TC are alternative options.

Status

Atualizada

Recomendado a favor

Condicional

Certeza da evidência

Muito baixa

Infant postnatal prophylaxis. Infants who are at high risk of acquiring HIV should receive a three-drug regimen, with ABC/3TC-DTG as the preferred option.

Status

Atualizada

Recomendado a favor

Forte

Certeza da evidência

Baixa

Infant postnatal prophylaxis.Breastfeeding infants who complete six weeks of a three-drug regimen should follow with single-drug prophylaxis until maternal viral suppression is achieved or for the remainder of breastfeeding. NVP is the preferred option

Status

Atualizada

Recomendado a favor

Forte

Certeza da evidência

Moderada

Infant postnatal prophylaxis.Breastfeeding infants who complete six weeks of a three-drug regimen should follow with single-drug prophylaxis until maternal viral suppression is achieved or for the remainder of breastfeeding. DTG is an alternative option

Status

Atualizada

Recomendado a favor

Condicional

Certeza da evidência

Muito baixa

Infant postnatal prophylaxis.Breastfeeding infants who complete six weeks of a three-drug regimen should follow with single-drug prophylaxis until maternal viral suppression is achieved or for the remainder of breastfeeding. 3TC is an alternative option

Status

Atualizada

Recomendado a favor

Condicional

Certeza da evidência

Moderada

As mães portadoras de HIV devem amamentar por pelo menos 12 meses e podem continuar amamentando por até 24 meses ou mais (semelhante à população em geral), ao mesmo tempo em que são totalmente apoiadas pela adesão à TARV (ver as orientações consolidadas da OMS sobre medicamentos ARV para intervenções a fim de otimizar a adesão).

Status

Mantida

Recomendado a favor

Forte

HIV and infant feeding. In settings where the national programme recommends replacement feeding: mothers living with HIV who are receiving ART and virally suppressed should be offered the choice of breastfeeding and supported in their infant feeding choice.

Status

Atualizada

Recomendado a favor

Forte

Certeza da evidência

Baixa

HIV and infant feeding. Offer enhanced community- and facility-based interventions to support mothers living with HIV who are breastfeeding in order to optimize ART adherence, improve retention of mother-and-infant pairs in care and optimize breastfeeding

Status

Atualizada

Recomendado a favor

Condicional

Certeza da evidência

Muito baixa

In adults and adolescents with HIV eligible for tuberculosis preventive treatment (TPT), three months of weekly isoniazid + rifapentine (3HP) is the suggested preferred regimen; six or nine months of daily isoniazid (6H or 9H) are alternative regimens.

Status

Nova

Recomendado a favor

Condicional

Certeza da evidência

Baixa