Clinical Guidelines > Current Guidelines >

BHIVA guidelines on antiretroviral treatment for adults living with HIV-1 2022 (2023 interim update)


The overall purpose of these guidelines is to provide guidance on best clinical practice for antiretroviral therapy (ART) and management of adults living with human immunodeficiency virus (HIV). The scope includes: (i) guidance on the initiation of ART in those previously naïve to therapy; (ii) support of people living with HIV on treatment; (iii) management of individuals experiencing virological failure; (iv) switch for tolerability and/or toxicity issues; and (v) recommendations for specific populations where other factors need to be taken into consideration. The guidelines are written for clinical professionals directly involved with and responsible for the care of adults living with HIV, community advocates responsible for promoting the best interests and care of adults living with HIV, and people living with HIV for whom a non-technical summary will also be available, if preferred. They should be read in conjunction with other published BHIVA guidelines.

The purpose of the 2023 interim update of the guidelines was to amend the ‘cardiovascular considerations’ section related to adjusting cardiovascular disease risk estimates for people living with HIV. This change, with the supporting evidence, is highlighted.


BHIVA guidelines on antiretroviral treatment for adults living with HIV-1 2022 (2023 interim update)NICE accredited

Appendix 1 Summary of the modified GRADE system
Appendix 2 PICO questions and literature search strategies
Appendix 3 Grade tables

Consultation comments
Comments received by the BHIVA Secretariat during the public consultation process and during the community consultation

Declaration of interest
Declaration of conflict of interest for the writing group

Non-technical summaries

View non-technical summary of the BHIVA treatment guidelines
View non-technical summary about injectable HIV treatment


Webcast of Dr Laura Waters summarising ART guidelines

Writing group

Laura Waters, Alan Winston (Vice-chair), Iain Reeves, Marta Boffito, Duncan Churchill, Ben Cromarty, David Dunn, Douglas Fink, Sarah Fidler, Caroline Foster, Julie Fox, Ravi Gupta, Andy Hilton, Saye Khoo, Clifford Leen, Nicola Mackie, Nadia Naous, Daisy Ogbonmwan, Chloe Orkin, Linda Panton, Frank Post, Anton Pozniak, Caroline Sabin, John Walsh (Chair)

Peer review/acknowledgements

The writing group thanks Prof Esteban Martinez, Hospital Clínic & University of Barcelona, Spain, and Dr Mark O'Reilly, Prahran Market Clinic, Victoria, Australia, for peer review of the guidelines. Particular thanks to Dr Catherine Nieman Sims for her tireless patience and hard work as BHIVA guidelines coordinator.

Guideline updates and date of next review

The guidelines are scheduled for full review in 2027.


Waters L, Winston A, Reeves I et al. BHIVA guidelines on antiretroviral treatment for adults living with HIV-1 2022. HIV Med 2022; 23 Suppl 5: 3-115.


View e-learning module