Updated guidelines for the therapy and prevention of HIV
A variety of antiretroviral drugs used to treat HIV infection.
The prevention and treatment of human immunodeficiency virus (HIV) infections has made great strides in recent years. At the same time, however, new challenges are emerging, for example in connection with outbreaks of other viral infectious diseases such as SARS-CoV-2 and monkeypox virus. As a member of an international expert committee, DZIF scientist Professor Clara Lehmann from the University Hospital Cologne contributed to the latest international recommendations for the treatment and prevention of HIV infections, which have now been published in the renowned Journal of the American Medical Association.
Four decades after the first cases of HIV were recorded, there have been major advances in the treatment of HIV infection with antiretroviral therapies and in HIV prevention through pre-exposure prophylaxis with drugs. However, as HIV treatment and prevention have improved, new challenges have emerged, including the fact that people living with HIV are now living much longer and face the health challenges of ageing. Particularly with late diagnosis and older age, antiretroviral therapy can lead to specific problems. These can be exacerbated by non-AIDS-related comorbidities, drug-drug interactions, and a generally higher risk of serious concomitant complications in the elderly.
To update the consensus recommendations last published in 2020, the International Antiviral Society-USA appointed an international panel of physician scientists, to which Prof. Clara Lehmann of the University Hospital of Cologne and the German Center for Infection Research (DZIF) was appointed. Based on critical assessment of new data, the expert panel developed a list of updated key recommendations between October 2021 and October 2022. In addition to guidelines for the initiation and regimen of antiretroviral therapy and biomedical HIV prevention, the list also includes recommendations for laboratory monitoring and care, particularly for older HIV-infected persons and drug users. The panel also developed recommendations on the problem of possible co-infection with other viruses such as SARS-CoV-2 and monkeypox.
"COVID-19 demonstrated how quickly scientists and public health can respond to address a pandemic when significant and sustained financial investments are made," says Prof. Lehmann. "For HIV, we also need to intensify our collaborative research efforts and provide relief through investment and regulatory action."
