British HIV Association guidelines for the treatment of HIV‐1‐positive adults with antiretroviral therapy 2012 (Updated November 2013. All changed text is cast in yellow highlight.)

Introduction Scope and purpose Methodology Guideline development process Patient involvement GRADE Good practice points Dissemination and implementation Guideline updates and date of next review Treatment aims Resource use Implications for research References Recommendations and auditable outcomes Recommendations (GRADE) Patient involvement in decision making (Section 3) When to start (Section 4) What to start (Section 5) Supporting patients on therapy (Section 6) Managing virological failure (Section 7) Antiretroviral therapies in specific populations (Section 8) Summary of auditable measures Patient involvement in decision-making Recommendations Rationale References When to start Chronic infection Recommendations Rationale References Patients presenting with AIDS or a major infection Recommendation Rationale References Treatment of primary HIV infection Recommendations Rationale References Treatment to reduce transmission Recommendations Rationale References What to start Summary recommendations Summary of auditable measures Introduction Which nucleoside reverse transcriptase inhibitor backbone Recommendations Rationale Not recommended References Which third agent Recommendations Rationale Not recommended References Novel antiretroviral therapy strategies Recommendation Rationale Reference Recommendation Rationale References Supporting patients on therapy Adherence Interventions to increase adherence to treatment Should the choice of first-line antiretroviral therapy combination be affected by risk of non-adherence? Dosing frequency Fixed-dose combinations References Pharmacology Drug interactions Therapeutic drug monitoring Stopping therapy: pharmacological considerations Switching therapy: pharmacological considerations References Switching antiretroviral therapy in virological suppression Introduction Switching antiretrovirals in combination antiretroviral therapy Protease inhibitor monotherapy Stopping therapy Recommendation Rationale References Managing virological failure Introduction Blips, low-level viraemia and virological failure Recommendations Rationale Patients with no or limited drug resistance Recommendations Rationale Patients with triple-class (non-nucleoside reverse transcriptase inhibitor, nucleoside reverse transcriptase inhibitor, protease inhibitor) virological failure with or without triple-class resistance Recommendations Rationale Patients with limited or no therapeutic options when a fully viral suppressive regimen cannot be constructed Recommendations Rationale References Antiretroviral therapy in specific populations HIV with tuberculosis coinfection When to start antiretroviral therapy What to start References HIV and viral hepatitis coinfection Introduction Hepatitis B Hepatitis C References HIV-related cancers Summary of auditable measures When to start antiretroviral therapy: AIDS-defining malignancies When to start antiretroviral therapy: non-AIDS-defining malignancies What to start References HIV-associated neurocognitive impairment Introduction When to start antiretroviral therapy What to start Modification of antiretroviral therapy References Chronic kidney disease When to start antiretroviral therapy What to start References Cardiovascular disease Introduction Definition and assessment of cardiovascular disease risk When to start antiretroviral therapy What to start References Women Introduction When to start What to start HIV-positive women experiencing virological failure References Acknowledgements Conflicts of interest statements List of abbreviations List of appendices Appendix 1: Summary modified GRADE system Appendix 2: Literature search Questions and PICO criteria Search protocols Appendix 3: GRADE tables Choice of nucleoside reverse transcriptase inhibitor backbone Choice of third agent Protease inhibitor monotherapy Appendix 4: BHIVA Treatment Guideline update 2013