These guidelines were developed by the British Columbia Centre for Excellence in HIV/AIDS (BC-CfE) and the Committee for Drug Evaluation and Therapy (CDET) for HIV care providers and provide recommendations for the treatment of adult HIV infection in BC. The BC-CfE encourages providers to exercise clinical judgment on a case by case basis and individualize care where appropriate.
The therapeutic guidelines document includes the following sections:
Guideline for Antiretroviral Therapy Regimens for Initial Therapy and for Switching ART in Virologically Stable Suppressed Adults
This section regular BC-CfE Drug Treatment Program formulary options for initial ART in adults with HIV infection as of Fall 2019, taking into consideration the CDET’s Scientific Review and recommendations as well as cost considerations. In the event where ART regimen switch is being considered in virologically suppressed individuals with no known resistance mutations or intolerance to specific agents, these ART options should also be considered. Prescribers requesting alternative ART are expected to provide justification and appropriate supportive documentation with the prescription request. Consistent with Pharmacare practices, the BC-CfE encourages the use of generics, including voluntary de-simplification of ART regimens, where appropriate.
BC-CfE Eligibility Criteria for Emtricitabine-Tenofovir Alafenamide (FTC/TAF; Descovy¨)
This section summarizes clinical criteria for BC-CfE Drug Treatment Program eligibility for FTC/TAF 200-25 mg and FTC/TAF 200-10 mg tablets. Justification and supportive documentation should accompany the HIV Drug Treatment Program Prescription Request Form for FTC/TAF.
Scientific Review and Recommendations for the Therapeutic Guidelines
This section includes the BC-CfE CDET review of the available evidence and scientific recommendations regarding the use of antiretroviral therapy (ART) in adults with HIV-1 infection
- When to start
- What to start with (For BC-CfE formulary options, please refer to Guideline for ART Regimens for Initial Therapy)
- Assessment and monitoring
- Changing antiretroviral therapy
- Adverse drug reactions of antiretroviral therapy