What are the current first-line antiretroviral therapies for newly diagnosed HIV patients?

First-line antiretroviral therapies (ART) for patients newly diagnosed with HIV are initiated and managed by specialist HIV services rather than in primary care. The choice of regimen is guided by specialist HIV clinicians based on current BHIVA guidelines and expert consensus.

While the provided UK guidelines do not specify exact first-line ART regimens in primary care documents, they emphasize that treatment initiation and monitoring, including CD4 count and viral load, are carried out in specialist clinics. ART typically involves combination therapy to suppress viral replication and improve prognosis, especially when started at CD4 counts above 500 cells/μL.

Primary care roles include supporting adherence, monitoring for drug interactions and adverse effects, and ensuring patients remain engaged with specialist services. Detailed medication history and checking for interactions using resources such as www.hiv-druginteractions.org and the British National Formulary are essential before any ART adjustments.

For specific first-line ART regimens, clinicians refer to BHIVA guidelines (2015, 2016 update) and expert reviews, which commonly recommend integrase strand transfer inhibitor (INSTI)-based regimens combined with two nucleoside reverse transcriptase inhibitors (NRTIs) as first-line therapy. However, these details are not explicitly listed in the provided excerpts.