European AIDS Clinical Society (EACS) has released guidelines which are revised every two years and updated in between as new evidence arises and the same has been published on 26 October 2017.Everyone with HIV and hepatitis C virus (HCV) co-infection should receive direct-acting antiviral treatment for hepatitis C and should receive the same treatment for hepatitis C as people with hepatitis C mono-infection, new European guidelines issued at the 16th European AIDS Conference (EACS 2017) recommend.
Some major additions and changes are as follows-
- Downgrading the use of atazanavir/ritonavir in first-line treatment owing to kidney toxicity in people taking the drugs.
- People with HIV should be considered for organ transplantation according to the same criteria as everyone else.
- Doctors should consider screening for non-alcoholic fatty liver disease, especially in people with metabolic syndrome, owing to the high prevalence of the condition in people with HIV.
- Screening for chronic lung disease should become standard practice in smokers and people over the age of 40.
- Human papillomavirus vaccination is now recommended for all people with HIV under 26 and all men who have sex with men up to the age of 40.
- For Viral hepatitis, the guidelines now recommend that people with HIV and HCV co-infection should receive direct-acting antiviral treatment for hepatitis C and should receive the same treatment for hepatitis C as people with hepatitis C monoinfection.
- Regarding Antiretroviral therapy, there are no changes in the first-line regimens recommended by EACS in the 2017 guidelines, except for a downgrading of atazanavir/ritonavir.
- Regarding Solid organ transplantation, a new section on solid organ transplantation has been added to the guidelines. The guidelines panel states that people living with HIV should be considered for organ transplantation using the same indications as used in HIV-negative people.
- Regarding Non-alcoholic fatty liver disease, New guidance on the management of non-alcoholic fatty liver disease (NAFLD) has been added, following the findings that around half of people with HIV referred for investigation after abnormal liver function tests turn out to have NAFLD.
- Regarding chronic lung disease including COPD, EACS recommends that all patients should be screened for chronic lung disease if they are aged 40 or over or if they have smoked for the equivalent of ten years. Regular wheezing, cough or shortness of breath on exertion should prompt further investigation in these people to diagnose COPD.
- Human papillomavirus (HPV) vaccination is now recommended for everyone living with HIV aged under 26 and all men who have sex with men up to the age of 40.
Full guidelines document is available at : http://www.eacsociety.org/guidelines/eacs-guidelines/eacs-guidelines.html
Dr. Kamal Kant Kohli
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