WHO: Optimization of second-line and third-line antiretroviral therapy for people living with HIV

Optimization of second-line and third-line antiretroviral therapy for people living with HIV - Meeting Report WHO November 2023

This meeting aimed to discuss clinical evidence, key challenges and research gaps for optimizing second-line and third-line antiretroviral therapy (ART) regimens included in current WHO treatment
guidelines as well as the advances in the management of adverse drug reactions and emerging drug resistance to these ART regimens from a public health perspective.

The following key points were addressed:
• reviewing the recent evidence on efficacy and safety, including programmatic data;
• identifying research gaps;
• aligning the needs for different populations (adults, children and pregnant women);
• assessing the potential of darunavir/ritonavir (DRV/r) as a preferred protease inhibitor (PI) option in second-line and third-line ART for adults, pregnant women and children;
• discussing the efficacy and safety of recycling tenofovir in second-line regimens;
• discussing the safety of regimens containing tenofovir alafenamide (TAF) and tenofovir disoproxil fumarate (TDF), with considerations raised regarding their different side-effect profiles and use with boosted and unboosted ART regimens; and
• plans for updating WHO guidelines on preferred ART regimens

Additional information to the following link: 9789240100299-eng.pdf (who.int)