Thread by @ABsteward

🔥 Just PUBLISHED 🔥
Antiretroviral Drugs for Treatment and Prevention of HIV Infection in Adults
2022 Recommendations of the International Antiviral Society–USA Panel
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jamanetwork.com/journals/jama/…

Initiation of ART is recommended as soon as possible after diagnosis, ideally within 7 days, including on the same day as diagnosis or at the first clinic visit if the patient is ready and there is no suspicion for a concurrent opportunistic infection (evidence rating: AIII)

Recommended for Most People With HIV
The following are recommended (in alphabetical order) for most people with HIV:

BIC/TAF/FTC (evidence rating: AIa)

Dolutegravir plus TXF/XTC (evidence rating: AIa)

DTG/3TC (only if HIV RNA <500 000 copies/mL and HBV coinfection not present). This regimen should not be used for rapid initiation when genotype, HIV RNA, and HBV serology results are not yet available (evidence rating: AIa

Persons who acquired HIV while receiving preexposure prophylaxis with tenofovir alafenamide or tenofovir disoproxil fumarate with emtricitabine should have a blood sample for genotyping drawn prior to initiating therapy and a 3-drug regimen,

Preferably dolutegravir or bictegravir plus TXF/XTC, should be initiated if ART is to be started before genotype results are available (evidence rating: AIII

Recommended During Pregnancy
TAF/XTC plus dolutegravir (evidence rating: AIa), withTDF/XTC plus dolutegravir a suitable alternative if tenofovir alafenamide is not available (evidence rating: AIa)

The following drugs may be used if dolutegravir is not an option:

Raltegravir (400 mg twice daily) (evidence rating: AIIa)

Atazanavir plus ritonavir (evidence rating: BIIa)

Darunavir plus ritonavir (evidence rating: BIIa)

Rilpivirine (evidence rating: BIIa