Help your patients get the benefits of ART when they restart HIV treatment

Using ART to achieve and maintain viral suppression is critical to reduce morbidity and mortality, improve immune function, and reduce the risk of HIV transmission. Achieving and maintaining viral suppression for at least 6 months prevents onward sexual transmission of HIV (U=U).² If patients stop taking ART for periods of time, it's important to reengage them at the earliest opportunity and support them in restarting ART.¹

Per the AETC, immediate ART restart is appropriate for¹:

• Nearly all PWH who are reengaging in care
• PWH for whom the ART history is known, and HIV resistance is known or can be predicted (based on previous resistance testing, HIV viral load while on ART, and adherence history)
• PWH for whom an appropriate ART regimen can be devised without information from current resistance test results

A resistance test may not be needed if new acquired resistance is unlikely (eg, for patients who had viral suppression at the time they discontinued ART). Resistance test results may not detect mutations if the patient has been off ART for about 4 weeks or more. Regimens should be selected individually, based on the patient’s specific HIV, ART, and resistance history; as well as their comorbidities, tolerance of previous ARVs, adherence challenges, and other factors. Consult with an expert.

Per the AETC, immediate ART restart is not appropriate for¹:

• Persons with certain untreated opportunistic infections (OIs), eg, central nervous system OIs, for whom a short period of treatment for the OI is recommended before ART initiation
• PWH for whom an appropriate ART regimen cannot be devised without information from current resistance test results