HIV/AIDS Diagnosis and Treatment: Korean Society for AIDS 2018 Guidelines

Korean Society for AIDS has updated it's 2011, 2013, and 2015 Clinical Guidelines for the Diagnosis and Treatment of HIV/AIDS. The clinical guidelines address the initial evaluation of patients diagnosed with HIV/AIDS, follow-up tests, appropriate timing of medication, appropriate antiretroviral medications, treatment strategies for patients who have concurrent infections with hepatitis B or C virus, and treatment in pregnant women. Through these clinical guidelines, the Korean Society for AIDS and the Committee for Clinical Guidelines for the Diagnosis and Treatment of HIV/AIDS would like to contribute to overcoming AIDS by delivering the latest data and treatment strategies to healthcare professionals who treat AIDS in the clinic.

1. What's new in the guidelines?

The following key changes have been made to update the 2015 guidelines

• 1. Tenofovir alafenamide/emtricitabine (TAF/FTC) is newly entered as a preferred nucleoside reverse transcriptase inhibitor (NRTI) backbone.


• 2. Dolutegravir (DTG) is newly entered as a preferred integrase strand transfer inhibitor (INSTI). However, DTG should be avoided for women with child bearing potential and during first 12 weeks of their pregnancy.


• 3. Efavirenz (EFV) is no longer a preferred non-nucleoside reverse transcriptase inhibitor (NNRTI) and reclassified as an alternative drug.


• 4. Darunarvir/cocistat (DRV/c) is newly entered as a preferred protease inhibitor (PI).


• 5. Atazanavir/ritonavir (ATV/r) and lopinavir/ritonavir (LPV/r) are no longer preferred PIs and reclassified as alternative drugs.


• 6. For the patient on a suppressive regimen whose CD4+ T cell count has consistently maintained, CD4+ T cell monitoring interval can be extended to every 6 months. Continued CD4+ T cell monitoring for virologically suppressed patients whose CD4+ T cell counts have been consistently >500 cells/mm³ for at least 2 years may be considered optional.


• 7. Rilpivirine (RPV) is introduced as a preferred NNRTI.


• 8. Elvitegravir (EVG)/cobicistat (COBI) is introduced as a preferred INSTI. It is available only as a single co-formulated tablet as tenofovir/emtricitabine/elvitegravir/cobicistat.


• 9. Didanosine (ddI)/lamivudine (3TC), which were advocated as an alternative NRTI backbone, are no longer recommended.


• 10. Sections on antiretroviral use in pregnant women have been added.


• 11. An updated human immunodeficiency virus (HIV)/hepatitis C virus (HCV) treatment guideline with direct-acting antiviral (DAA) therapy has been added.


• 12. EFV can be used as an alternative in pregnant women who wish to take medications once daily.