1C 8.5.2 We recommend against the use of ARV drugs that are potentially nephrotoxic, in patients with stages 3–5 chronic kidney disease (CKD) if acceptable alternative ARV agents are available. GPP   We recommend dose adjustment of renally cleared ARV drugs in patients with reduced renal function. GPP 8.6.4 We suggest avoiding: ABC, FPV/r and LPV/r in patients with a high cardiovascular disease (CVD) risk, if acceptable alternative ARV drugs are available. 2C 8.7.2 We recommend therapy-naïve HIV-positive women who are not pregnant start ART according to EPZ-6438 purchase the same indicators as in men (see Section 4: When to Start) 1A 8.7.3 We recommend therapy-naïve

HIV-positive women start ART containing two NRTIs and one of the following: PI/r, NNRTI or INI, as per therapy-naïve HIV-positive men. 1A   We recommend therapy-naïve HIV-positive women start ART with preferred or alternative NRTI backbone and third agent as per therapy-naïve HIV-positive men (see Section 5.1: What to start: summary recommendations). Factors such as potential side effects, co-morbidities, drug interactions, patient preference and dosing convenience need to be considered in selecting ART in individual women. Percentage of patients who confirm they have been given the opportunity to be involved in making decisions about their treatment. Proportion of patients with CD4 cell count <350 cells/μL not on ART. Proportion of patients

with CD4 cell count >350 cells/μL and an indication to start ART on ART. Proportion of patients presenting with an AIDS-defining infection or with a serious click here bacterial infection and a CD4 cell count <200 cells/μL started on ART within 2 weeks of initiation of specific antimicrobial chemotherapy.

Proportion of patients presenting with PHI and neurological involvement, or an AIDS-defining illness or confirmed CD4 cell count <350 cells/μL started on ART. Record in patient's notes of discussion, treatment with ART lowers risk of HIV transmission Bacterial neuraminidase and an assessment of current risk of transmission. Proportion of therapy-naïve patients not starting ART containing two NRTIs and one of the following: PI/r, NNRTI or INI (preferred or alternative agents). Proportion of patients starting ART with TDF/FTC or ABC/3TC as the NRTI backbone. Proportion of patients starting ART with ATV/r, DRV/r, EFV or RAL as the third agent. Proportion of patients with undetectable VL <50 copies/mL at 6 and 12 months after starting ART. Proportion of patients who switch therapy in the first 6 and 12 months. Record in patient’s notes of HLA-B*57:01 status before starting ABC. Record in patient’s notes of discussion and assessment of adherence and potential barriers to, before starting a new ART regimen and while on ART. Record in patient’s notes of provision or offer of adherence support. Record in patient’s notes of potential adverse pharmacokinetic interactions between ARV drugs and other concomitant medications.