2019 Ryan White HIV/AIDS Program CLINICAL CONFERENCE

RPV g DOR

Alternative g

Continue g

Alternative g

Alternative g

Alternative g

Insufficientdata

Insufficientdata

Insufficientdata

Insufficientdata

Insufficientdata

ETR

Not recommended

Continue

Not recommended, except inspecial circumstances h

Not recommended, except in specialcircumstances h

Not recommended, except in special circumstances h

NVP

Not recommended

Continue

Not recommended, except inspecial circumstances h

Not recommended, except in specialcircumstances h

Not recommended, except in special circumstances h

NRTIs d,i ABC

Preferred Preferred Preferred Preferred Alternative

Continue Continue Continue Continue Continue Continue

Preferred Preferred Preferred Preferred Alternative

Preferred Preferred Preferred Preferred Alternative

Preferred Preferred Preferred Preferred Alternative

FTC 3TC TDF ZDV TAF

Insufficientdata j

Insufficientdata

Insufficientdata

Insufficientdata

EntryandFusion Inhibitors IBA

Insufficientdata

Insufficientdata

Insufficientdata

Insufficientdata

Insufficientdata

MVC

Not recommended

Continue

Not recommended, except inspecial circumstances h

Not recommended, except in specialcircumstances h

Not recommended, except in special circumstances h

T-20

Not recommended

Continue

Not recommended, except inspecial circumstances h

Not recommended, except in specialcircumstances h

Not recommended, except in special circumstances h

FDCRegimens f The individualdrugcomponentthat ismostresponsiblefortheoverallrecommendationis indicated inparentheses. ABC/DTG/3TC e Preferred e Continue e Preferred e

Preferred e

Alternative e

EFV/FTC/TDF EFV/3TC/TDF FTC/RPV/TDF BIC/FTC/TAF

Alternative(EFV) Alternative(EFV) Alternative(RPV i )

Continue Continue

Alternative(EFV) Alternative(EFV) Alternative(RPV i )

Alternative(EFV) Alternative(EFV) Alternative(RPV i )

Alternative(EFV) Alternative(EFV) Alternative(RPV i )

Continue (RPV i )

Insufficientdata (BIC,TAF)

Insufficientdata (BIC)

Insufficientdata (BIC,TAF)

Insufficientdata (BIC,TAF)

Insufficientdata (BIC, TAF)

DOR/3TC/TDF

Insufficientdata (DOR)

Insufficientdata (DOR)

Insufficientdata (DOR)

Insufficientdata (DOR)

Insufficientdata (DOR)

Slide31of42FromJRAnderson,MDatNewOrleans,LA,December4-7,2019,RyanWhiteHIV/AIDSProgramCLINICALCONFERENCE, IAS  USA.

FTC/RPV/TAF

Insufficientdata (TAF f ) Notrecommended (EVG/COBI f )

Continue(RPV g , TAF f ) Considerswitchor continuewith frequentviral load

Insufficientdata (TAF f ) Notrecommended (EVG/COBI f )

Insufficientdata(TAF f )

Insufficientdata (TAF f ) Not recommended (EVG/COBI f )

EVG/COBI/FTC/TD F

Notrecommended (EVG/COBI f )

monitoring (EVG/COBI f )

EVG/COBI/FTC/TA F

Notrecommended f (EVG/COBI h )

Considerswitchor continuewith frequentviral load

Notrecommended (EVG/COBI f )

Notrecommended (EVG/COBI f )

Not recommended (EVG/COBI f )

monitoring (EVG/COBI f )

DRV/COBI/FTC/TA F

Notrecommended (DRV/COBI f )

Considerswitchor continuewith frequentviral load

Notrecommended (DRV/COBI f )

Notrecommended (DRV/COBI f )

Not recommended (DRV/COBI f )

monitoring (DRV/COBI f )

DTG/3TC Asa complete regimen k DTG/RPV Asa complete regimen k

Notrecommended e,k Notrecommended (DTG,3TC e,k ), switch oraddadditional agents

Notrecommended e,k Notrecommended e,k

Not recommended e,k

Notrecommended k

Notrecommended, switchoradd additionalagents (DTG e /RPV g,k )

Notrecommended e,k Notrecommended e,k

Not recommended e,k

Slide32of42FromJRAnderson,MDatNewOrleans,LA,December4-7,2019,RyanWhiteHIV/AIDSProgramCLINICALCONFERENCE, IAS  USA.

USPHS Perinatal Guidelines: Breastfeeding

• Breastfeeding is NOT RECOMMENDED for women living with HIV in US (AII) • However, women who have questions about breastfeeding or a desire to breastfeed should receive patient-centered, evidence-based counseling on infant feeding options (AIII) • When a woman with HIV chooses to breastfeed after counseling, a harm-reduction approach should be taken to help minimize the risk of HIV transmission to their infant.

Slide33of42FromJRAnderson,MDatNewOrleans,LA,December4-7,2019,RyanWhiteHIV/AIDSProgramCLINICALCONFERENCE, IAS  USA.