Guideline

Guideline on when to start antiretroviral therapy and on pre-exposure prophylaxis for HIV

Year of Publication

2015

Issuing Institution

World Health Organization

Links

WHO IRIS,WHO IRIS

Recommendations

12 included recommendations

ART should be initiated in all adults living with HIV at any CD4 cell count

Status

Updated

Recommended in favor

Strong

Certainty of evidence

Moderate

As a priority, ART should be initiated in all adults with severe or advanced HIV clinical disease (WHO clinical stage 3 or 4) and individuals with CD4 count ≤350 cells/mm

Status

Maintained

Certainty of evidence

Moderate

ART should be initiated in all pregnant and breastfeeding women living with HIV, regardless of WHO clinical stage and at any CD4 cell count and continued lifelong

Status

Maintained

Recommended in favor

Strong

Certainty of evidence

Moderate

ART should be initiated in all adolescents living with HIV at any CD4 cell count

Status

Updated

Recommended in favor

Conditional

Certainty of evidence

Low

As a priority, ART should be initiated in all adolescents with severe or advanced HIV clinical disease (WHO clinical stage 3 or 4) and adolescents with a CD4 count ≤350 cells/mm3

Status

Maintained

Recommended in favor

Strong

Certainty of evidence

Moderate

ART should be initiated in all children 1 to <10 years old living with HIV at any CD4 cell count

Status

Retired

As a priority, ART should be initiated in all children <2 years of age or children younger than 5 years of age with WHO clinical stage 3 or 4 or CD4 count ≤750 cells/mm³ or CD4 percentage <25% and children 5 years of age and older with WHO clinical stage 3 or 4 or CD4 count ≤350 cells/mm³

Status

Maintained

Recommended in favor

Strong

Certainty of evidence

Moderate

ART should be initiated in all children living with HIV younger than 1 year old at any CD4 cell count

Status

Updated

Recommended in favor

Strong

Certainty of evidence

Moderate

Oral PrEP (containing tenofovir disoproxil fumarate (TDF)) should be offered as an additional prevention choice for people at substantial risk of HIV infection as part of combination prevention approaches

Status

Updated

Recommended in favor

Strong

Certainty of evidence

High

TB and HIV coinfection: ART should be recommended for all people with TB who are living with HIV at any CD4 cell count

Status

Updated

Recommended in favor

Strong

Certainty of evidence

Low

HBV and HIV coinfection: ART should be initiated at any CD4 cell count if the person has severe chronic liver disease

Status

Updated

Recommended in favor

Strong

Certainty of evidence

Low

People with HIV in serodiscordant couples and who are started on antiretroviral therapy (ART) for their own health should be advised that ART is also recommended to reduce HIV transmission to the uninfected partner.

Status

Updated

Recommended in favor

Strong

Certainty of evidence

High