28
Presence of Other
Conditions
(cont'd)
Cardiac QTc interval
prolongation
Consider avoiding EFV- or RPV-based
regimens if taking other medications with
known risk of TdP, or in patients at higher
risk of TdP.
Hyperlipidemia e following ARV drugs have been
associated with dyslipidemia:
• PI/r or PI/c
• EFV
• EVG/c
Patients with history
of poor adherence to
ARV or inconsistent
engagement in care
Consider boosted PI- or DTG-based
regimens.
Pregnancy Refer to the Perinatal Guidelines at
http://aidsinfo.nih.gov/guidelines
Presence of
Coinfections
HBV infection • Use TDF or TAF, with FTC or 3TC,
whenever possible.
If TDF and TAF are Contraindicated:
• For treatment of HBV, use FTC or 3TC
with entecavir and a suppressive ART
regimen (see HBV/HIV Coinfection at
http://aidsinfo.nih.gov/guidelines).
HCV treatment
required
Refer to recommendations for HCV/HIV
Coinfection at http://aidsinfo.nih.gov/
guidelines with special attention to
potential interactions between ARV drugs
and HCV drugs.
Treating TB
disease with
rifamycins
TAF is NOT recommended with any
rifamycin-containing regimen.
If Rifampin is Used:
• EFV can be used without dosage
adjustment.
• If RAL is used, increase RAL dose to
800 mg bid.
• Use DTG at 50 mg bid dose only
in patients without selected INSTI
mutations (refer to product label).
If using a PI-based regimen, rifabutin
should be used in place of rifampin in the
TB regimen.
a
TAF and TDF are two approved forms of tenofovir. TAF has less bone and kidney toxicities than
TDF, whereas TDF is associated with lower lipid levels. Safety, cost, and access are among the
factors to consider when choosing between these drugs.
Selecting a Treatment Regimen
Table 7. Antiretroviral Regimen Considerations as Initial
Therapy based on Specific Clinical Scenarios (cont'd)
Patient or
Regimen
Characteristics Clinical Scenario Consideration(s)
