Monograph: Antiretroviral Agents General Statement

Antiretroviral Agents General Statement

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Full Title

Antiretroviral Agents General Statement

Classification

Classification of Antiretroviral Agents

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HIV NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NRTIs)

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Fixed Combinations Containing Only NRTIs

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HIV NUCLEOTIDE REVERSE TRANSCRIPTASE INHIBITORS

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Fixed Combinations Containing TAF

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Fixed Combinations Containing TDF

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HIV INTEGRASE INHIBITORS (INSTIs)

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Fixed Combinations Containing INSTIs

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HIV NONNUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NNRTIs)

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Fixed Combinations Containing NNRTIs

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HIV PROTEASE INHIBITORS (PIs)

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Fixed Combinations Containing PIs

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HIV ENTRY AND FUSION INHIBITORS

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Guidelines for Use of Antiretroviral Agents for Management of HIV Infection

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Laboratory Monitoring

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Diagnostic HIV Testing

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Plasma HIV-1 RNA Levels and CD4+ T-cell Counts

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Recommended Frequency of Plasma HIV-1 RNA Level and CD4+ T-cell Count Testing

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Interpretation of Plasma HIV-1 RNA Levels and CD4+ T-cell Counts

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In Vitro Resistance Testing

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Recommendations Regarding In Vitro Resistance Testing

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Coreceptor Tropism Assay

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Human Leukocyte Antigen (HLA)-B*5701 Screening

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Therapeutic Drug Monitoring

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Adverse Effects

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Drug Interactions

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Drug Interactions Among the Antiretroviral Agents

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Pharmacokinetic Enhancers

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HCV Antivirals

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Antimycobacterial Agents

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Illicit Drugs and Drugs Used to Treat Opioid Addiction

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Initial Antiretroviral Therapy in Antiretroviral-naive Adults and Adolescents

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Recommended Regimens for Initial Antiretroviral Therapy in Adults and Adolescents

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Table 1. Recommended Antiretroviral Regimens for Initial Therapy in Most Antiretroviral-naive Adults and Adolescents200

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Table 2. Recommended Antiretroviral Regimens for Initial Therapy in Antiretroviral-naive Adults and Adolescents in Certain Clinical Situations200

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Recommended Dual NRTI Options

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NRTI Pairings Not Recommended for Initial Therapy

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Antiretrovirals Not Recommended for Initial Therapy

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Antiretrovirals and Regimens Not Recommended at Any Time

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Antiretroviral Therapy in Antiretroviral-experienced Adults and Adolescents

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Management of Treatment Regimen Failure

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Virologic Failure

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Suboptimal Immunologic Response

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Considerations When Modifying an Antiretroviral Regimen

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Optimizing Antiretroviral Therapy in the Setting of Virologic Suppression

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Strategies Not Recommended in the Setting of Virologic Suppression

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Antiretroviral Therapy in Pediatric Patients

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Safety of Antiretrovirals In Pediatric Patients

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HIV Nucleoside Reverse Transcriptase Inhibitors (NRTIs)

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HIV Integrase Inhibitors (INSTIs)

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HIV Nonnucleoside Reverse Transcriptase Inhibitors (NNRTIs)

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HIV Protease Inhibitors (PIs)

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HIV Entry and Fusion Inhibitors

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Initial Antiretroviral Therapy in Antiretroviral-naive Pediatric Patients

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Table 3. Preferred and Alternative Antiretroviral Regimens for Initial Therapy in Antiretroviral-naive Pediatric Patients201

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Recommended Dual NRTI Options in Pediatric Patients

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Table 4. Dual NRTI Options for Use in Initial NNRTI-, INSTI-, or PI-based Regimens in Pediatric Patients201

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Antiretrovirals and Regimens Not Recommended in Pediatric Patients

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Antiretroviral Therapy in Previously Treated Pediatric Patients

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Antiretroviral Therapy During Pregnancy

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HIV Testing During Pregnancy

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Safety and Choice of Antiretrovirals During Pregnancy

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HIV Nucleoside Reverse Transcriptase Inhibitors (NRTIs) and Dual NRTI Options

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HIV Integrase Inhibitors (INSTIs)

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HIV Nonnucleoside Reverse Transcriptase Inhibitors (NNRTIs)

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HIV Protease Inhibitors (PIs)

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HIV Entry and Fusion Inhibitors

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Antiretrovirals for Prevention of Perinatal HIV Transmission

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Risk of Perinatal HIV Transmission

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Intrapartum Zidovudine for Prevention of Perinatal HIV Transmission

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Antiretrovirals in HIV-exposed Neonates

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Antiretrovirals for Prevention of Sexual Transmission of HIV (TasP)

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Antiretrovirals for Preexposure Prophylaxis for Prevention of HIV-1 Infection (PrEP)

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Emtricitabine/TDF and Emtricitabine/TAF Preexposure Prophylaxis for Prevention of HIV-1 Infection (PrEP)

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Recommendations for Preexposure Prophylaxis for Prevention of HIV-1 Infection (PrEP)

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Antiretrovirals for Postexposure Prophylaxis following Occupational Exposure to HIV (PEP)

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Occupational Exposures Associated with Risk of HIV Infection

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Percutaneous Exposure

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Mucous-membrane Exposure

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Skin Exposure

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Choice of Antiretroviral Agents for Postexposure Prophylaxis following Occupational Exposure to HIV (PEP)

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Safety and Efficacy of HIV Postexposure Prophylaxis (PEP)

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Prophylaxis Failures

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Adverse Effects of PEP Regimens

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Management of Occupational Exposures to HIV

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Assessment of the Type of Occupational Exposure and Associated Risk

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Evaluation and Testing of the Source

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Initial Evaluation and Testing of Exposed Health-care Personnel

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Initiation and Duration of PEP

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Follow-up and Counseling of Exposed Health-care Personnel

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Situations for Which Expert Consultation Regarding PEP Is Advised

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USPHS Recommendations Regarding PEP

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Antiretrovirals for Postexposure Prophylaxis following Sexual, Injection Drug Use, or other Nonoccupational Exposures to HIV (nPEP)

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Nonoccupational Exposures Associated with Risk of HIV Infection

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Management of Nonoccupational Exposure to HIV

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CDC Recommendations Regarding nPEP

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Antiretrovirals in the Management of Coronavirus Disease 2019 (COVID-19)

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Clinical Experience and Trials of HIV Protease Inhibitors in Patients with COVID-19

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Common monograph Elements

Related Monographs

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References

References

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Copyright

AHFS® Drug Information. © Copyright, 1959-2020, Selected Revisions September 21, 2020. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814.

† Use is not currently included in the labeling approved by the US Food and Drug Administration.

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AHFS Drug Information