New Evidence Available
Updated Recommendation
A new evidence synthesis was published:2025, WHO updated recommendations on HIV clinical management: recommendations for a public health approach
View latest version (2025)Bibliographic Info
GuidelineConsolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach
Year of Publication2016
Issuing InstitutionWHO
Recommendation
Status
Retired
Recommended in favor
Strong
Certainty of evidence
Moderate
Second-line ART in adults should consist of two nucleoside reverse-transcriptase inhibitors (NRTIs) plus a ritonavir-boosted protease inhibitor (PI). The following sequence of second-line nucleoside reverse transcriptase inhibitor (NRTI) options is recommended:
- After failure on a tenofovir disoproxil fumarate (TDF) + lamivudine (3TC) or emtricitabine (FTC)-based first-line regimen, use AZT + 3TC as the NRTI backbone in second-line regimens.
- After failure on an zidovudine (AZT) or stavudine (d4T) + 3TC-based first-line regimen, use TDF + 3TC (or FTC) as the NRTI backbone in second-line regimens.