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BHIVA guidelines for the treatment of HIV-1-positive adults with antiretroviral therapy 2015 (2016 interim update)


The overall purpose of these guidelines is to provide guidance on best clinical practice in the treatment and management of adults with HIV infection on antiretroviral therapy (ART).

The scope includes: (i) guidance on the initiation of ART in those previously naïve to therapy; (ii) support of people living with HIV (PLWH) on treatment; (iii) management of individuals experiencing virological failure; and (iv) recommendations in specific populations where other factors need to be taken into consideration.

The guidelines are aimed at clinical professionals directly involved with and responsible for the care of adults with HIV infection, and at community advocates responsible for promoting the best interests and care of HIV-positive adults. They should be read in conjunction with other published BHIVA guidelines.

The 2016 interim update to the 2015 BHIVA antiretroviral guidelines has been published online to include tenofovir-alafenamide/emtricitabine as a preferred NRTI backbone for first-line therapy. Changes were based on new data and the consensus opinion of the writing committee. All changes to the guideline are highlighted and include updates to the chronic kidney disease and bone disease sections of special populations and some small changes to managing virological failure.

The 2019 interim statement provides updated advice on treatment with two-drug regimens.


BHIVA guidelines for the treatment of HIV-1-positive adults with antiretroviral therapy 2015 (2016 interim update)NHS Evidence accredited provider

BHIVA treatment guidelines: 2019 interim statement on two-drug regimens

Appendices for these guidelines

Appendix 1 Summary of the modified GRADE system
Appendix 2 PICO questions and search strategies
Appendix 3 Grade tables
Appendix 4 Food considerations for antiretrovirals
Appendix 5 Considerations for antiretrovirals in renal impairment

Consultation Comments (2015)
The comments with replies from the Writing group can be downloaded here:
Download the comments received by the BHIVA Secretariat during the web consultation process

Presentation on these guidelines is available to download and use to facilitate dissemination and implementation of the BHIVA guidance.
Download the PDF
Download the Powerpoint Presentation

Writing Group (2016)

Laura Waters (Chair)
N Ahmed, B Angus, M Boffito, M Bower, D Churchill, D Dunn, S Edwards, C Emerson, S Fidler, †M Fisher, R Horne, S Khoo, C Leen, N Mackie, N Marshall, F Monteiro, M Nelson, C Orkin, A Palfreeman, S Pett, A Phillips, F Post, A Pozniak, I Reeves, C Sabin, R Trevelion, J Walsh, E Wilkins, I Williams, A Winston

†Professor Martin Fisher died in April 2015 - he made a significant contribution to these, many other guidelines and our speciality as a whole - he is greatly missed. 

Guidelines updates and date of next review

The guidelines will be next fully updated and revised in 2017. However, the writing group will continue to meet regularly to consider new information from high-quality studies and publish amendments and addendums to the current recommendations before the full revision date where this is thought to be clinically important to ensure continued best clinical practice.