DOH issues new guidelines on HIV antiretroviral therapy
Updated: Jul 31
July 8, MANILA - The Department of Health issued a new policy and set of guidelines for the treatment of people living with HIV and HIV-exposed infants. DOH Administrative Order No. 2022-0024 entitled "Guidelines on Differentiated Treatment for People Living with Human Immunodeficiency Virus (PLHIV) and Prophylaxis for HIV-Exposed Infants" was signed on behalf of former Secretary Francisco T. Duque III on June 30, 2022.
Part of the policy's rationale reads:
Strategic approaches on "test early," "treat early," and "treat all" remove limitations on ART initiation. Likewise, viral suppression achieved through high adherence to optimized and life-saving ART significantly reduces the risk of HIV transmission to sexual and drug-sharing partners.
Updated World Health Organization (WHO) treatment guidelines recommend the use of Dolutegravir (DTG) as preferred first-line ART regimen due to rapid viral suppression, low toxicity, fewer drug interactions, and high genetic barrier to developing HIV drug resistance. Use of optimized ART regimens and employing a differentiated or person-centered approach in the delivery of HIV treatment services will bring us one step closer towards achieving universal access to HIV treatment and care, ending AIDS as a public health threat and attainment of goals of the Universal Health Care Act and FOURmula ONE (FI) for Health.
The following are the general guidelines included in this issuance:
Antiretroviral therapy (ART) shall be initiated within the same day upon recognition of HIV infection, whenever possible, regardless of clinical and immunologic status.
Early initiation of ART in patients with opportunistic infection (OI) reduces risk of mortality. However, ART initiation should be delayed in patients being treated for Tuberculosis (TB) meningitis, cryptococcal meningitis, and cytomegalovirus (CMV) retinitis to prevent immune reconstitution inflammatory syndrome (IRIS).
Adherence shall be assessed and reinforced at every follow-up consultation to prevent drug resistance and treatment failure.
Patients who are already established on ART shall be maintained and monitored on their current ART regimen and providers shall employ multi-month dispensing.
All HIV-exposed infants shall be given ARV prophylaxis starting at birth or when HIV exposure is recognized postpartum.
Download and read A.O. No. 2022-0024: