CHIP, Center of Excellence for Health, Immunity and Infections, Department of Infectious Diseases, Section 2100, Center for Cardiac, Vascular, Pulmonary and Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
University College Dublin Centre for Experimental Pathogen Host Research, Dublin, Ireland.
HIV Med. 2020 Nov;21(10):617-624. doi: 10.1111/hiv.12878. Epub 2020 Sep 3.
The European AIDS Clinical Society (EACS) Guidelines cover key aspects of HIV management with major updates every two years.
The 2019 Guidelines were extended with a new section focusing on drug-drug interactions and other prescribing issues in people living with HIV (PLWH). The recommendations for treatment-naïve PLWH were updated with four preferred regimens favouring unboosted integrase inhibitors. A two-drug regimen with dolutegravir and lamivudine, and a three-drug regimen including doravirine were also added to the recommended initial regimens. Lower thresholds for hypertension were expanded to all PLWH and for cardiovascular disease prevention, the 10-year predicted risk threshold for consideration of antiretroviral therapy (ART) modification was lowered from 20% to 10%. Frailty and obesity were added as new topics. It was specified to use urine albumin to creatinine ratio to screen for glomerular disease and urine protein to creatinine ratio for tubular diseases, and thresholds were streamlined with the Kidney Disease: Improving Global Outcomes (KDIGO) recommendations. Hepatitis C virus (HCV) treatment recommendations were split into preferred and alternative treatment options. The algorithm for management of recently acquired HCV infection was updated and includes recommendations for early chronic infection management. Treatment of resistant tuberculosis (TB) was streamlined with the World Health Organization (WHO) recommendations, and new tables on immune reconstitution inflammatory syndrome, on when to start ART in the presence of opportunistic infections and on TB drug dosing were included.
The EACS Guidelines underwent major revisions of all sections in 2019. They are available in four different formats including a new interactive web-based version and are translated into Chinese, French, German, Japanese, Portuguese, Russian and Spanish.
欧洲艾滋病临床学会 (EACS) 指南涵盖了 HIV 管理的关键方面，每两年进行一次重大更新。
2019 年指南增加了一个新的章节，重点关注 HIV 感染者（PLWH）中的药物相互作用和其他处方问题。针对初治 PLWH 的建议进行了更新，推荐了四种首选方案，优先选择未增强的整合酶抑制剂。还增加了包含多替拉韦和拉米夫定的二药方案以及包含度鲁特韦的三药方案作为推荐的初始方案。将高血压的阈值扩大到所有 PLWH，为了预防心血管疾病，将考虑改变抗逆转录病毒治疗（ART）的 10 年预测风险阈值从 20%降低到 10%。脆弱和肥胖被添加为新的主题。指定使用尿白蛋白/肌酐比值筛查肾小球疾病，使用尿蛋白/肌酐比值筛查肾小管疾病，并与肾脏病：改善全球结果 (KDIGO) 建议相一致简化阈值。丙型肝炎病毒 (HCV) 治疗建议分为首选和替代治疗方案。最近获得的 HCV 感染管理算法进行了更新，包括早期慢性感染管理的建议。耐多药结核病 (TB) 的治疗与世界卫生组织 (WHO) 的建议相一致，并纳入了关于免疫重建炎症综合征的新表格、在存在机会性感染时何时开始 ART 以及 TB 药物剂量的表格。
EACS 指南在 2019 年对所有章节进行了重大修订。它们有四种不同的格式，包括一个新的交互式网络版本，并翻译成中文、法语、德语、日语、葡萄牙语、俄语和西班牙语。
