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Guideline

Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: recommendations for a public health approach

Year of Publication
2021
Issuing Institution
WHO
Links
WHO IRIS,Pubmed,Google Scholar,WHO IRIS

Recommendations

222 included recommendations

Women who disclose any form of violence by an intimate partner (or other family member) or sexual assault by any perpetrator should be offered immediate support. Health-care providers should, as a minimum, offer first-line support when women disclose violence. If healthcare providers are unable to provide first-line support, they should ensure that someone else (within their health-care setting or another that is easily accessible) is immediately available to do so

Status
Maintained

Recommended in favor

Strong

All people living with HIV with a positive cryptococcal antigen result on screening should be carefully evaluated for signs and symptoms of meningitis and undergo a lumbar puncture, if feasible, with cerebrospinal fluid (CSF) examination and India ink or CSF cryptococcal antigen assay to exclude active cryptococcal disease. India ink has low sensitivity, and a negative result on India ink should be confirmed by CSF cryptococcal antigen testing. When cryptococcal antigen screening is not available, fluconazole primary prophylaxis should be given to adults and adolescents living with HIV who have a CD4 count <100 cells/mm3

Status
Maintained

(All people living with HIV with a positive cryptococcal antigen result on screening should be carefully evaluated for signs and symptoms of meningitis and undergo a lumbar puncture, if feasible, with CSF examination and India ink or CSF cryptococcal antigen assay to exclude active cryptococcal disease. India ink has low sensitivity, and a negative result on India ink should be confirmed by CSF cryptococcal antigen testing. When cryptococcal antigen screening is not available, fluconazole primary prophylaxis should be given to adults and adolescents living with HIV who have a CD4 count <100 cells/mm3) This may be considered at a higher CD4 cell count threshold of <200 cells/mm

Status
Maintained

In settings with high TB transmission, adults and adolescents living with HIV who have an unknown or a positive latent TB infection test and are unlikely to have active TB disease should receive at least 36 months of daily isoniazid preventive therapy. Daily isoniazid preventive therapy for 36 months should be given whether or not the person is receiving ART and irrespective of the degree of immunosuppression, history of previous TB treatment and pregnancy in settings considered to have high TB transmission as defined by national authorities

Status
Maintained

Recommended in favor

Conditional

In all settings (and regardless of whether delivered through facility- or community-based testing), it is recommended that serological testing for HCV antibodya be offered with linkage to prevention, care and treatment services to the following individuals: • adults and adolescents from populations most affected by HCV infection (who are either part of a population with high HCV seroprevalence or have a history of exposure to and/or high-risk behaviour for HCV infection); and • adults, adolescents and children for whom chronic viral hepatitis is clinically suspected (through symptoms, signs orlaboratory markers)

Status
Updated

Recommended in favor

Strong

In settings with a ≥2% or ≥5% HCV antibody seroprevalence in the general population, it is recommended that all adults have access to and be offered HCV serological testing with linkage to prevention, care and treatment services. General population testing approaches should make use of existing community- or facility-based testing opportunities or programmes such as HIV or TB clinics, drug treatment services and antenatal clinics

Status
Maintained

Recommended in favor

Conditional

(In settings with a ≥2% or ≥5% HCV antibody seroprevalence in the general population, it is recommended that all adults have access to and be offered HCV serological testing with linkage to prevention, care and treatment services. General population testing approaches should make use of existing community- or facility-based testing opportunities or programmes such as HIV or TB clinics, drug treatment services and antenatal clinics) This approach may be applied to specific identified birth cohorts of older people at higher risk of infection and morbidity within populations that have an overall lower general prevalence

Status
Maintained

Recommended in favor

Conditional

WHO suggests that women living with HIV who have been treated for histologically confirmed CIN2/3 or adenocarcinoma in situ or treated as a result of a positive screening test be retested in 12 months with HPV DNA testing when available rather than with cytology or inspection of the cervix with acetic acid (VIA) or co-testing, and, if negative, be retested again at 12 months and, if negative again, move to the recommended screening interval

Status
Updated

Recommended in favor

Conditional

For people who present with vaginal discharge, WHO recommends treatment for N. gonorrhoeae and/or C. trachomatis and/or T. vaginalis on the same visit. WHO suggests treatment based on the results of quality-assured molecular assays for N. gonorrhoeae and/or C. trachomatis and/or T. vaginalis. In settings in which treatment based on the results of molecular assay in the same visit is not feasible or that have limited or no molecular testing, WHO suggests treatment based on testing with quality-assured rapid point-of-care tests or on syndromic treatment

Status
Updated

Recommended in favor

Strong

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