LAUSR

Abstract The Swedish Medical Products Agency and the Swedish Reference Group for Antiviral Therapy (RAV) have jointly published recommendations for the treatment of HIV infection on seven previous occasions (2002, 2003, 2005, 2007, 2009, 2011 and 2014). In February 2016, an expert group under the guidance of RAV once more revised the guidelines. The most important updates in the present guidelines are as follows: Tenofovir alafenamide (TAF) has recently been registered. TAF has several advantages over tenofovir disoproxilfumarate (TDF) and is recommended instead of TDF in most cases. First-line treatment for previously untreated individuals includes dolutegravir, boosted darunavir or efavirenz with either abacavir/lamivudine or tenofovir (TDF/TAF)/emtricitabine. Pre-exposure prophylaxis (PrEP) is recommended for high-risk individuals. As in the case of the previous publication, recommendations are evidence-graded in accordance with the Oxford Centre for Evidence Based Medicine (http://www.cebm.net/oxford-centre-evidence-based-medicine-levels-evidence-march-2009/) (Table 1). This document does not cover treatment of opportunistic infections and tumours. Table 1. Levels of evidence and recommendation (http://www.Cebm.Net/oxford-centre-evidence-based-medicine-levels-evidence-march-2009/).Quality grading of evidence base1a Systematic review (with homogeneity) of randomized controlled trials1b Individual randomized controlled trials with narrow confidence intervals1c ‘All or none’ all patients died before the treatment became available, but some now survive on it; or when some patients died before the treatment became available, but none now die on it.2a Systematic review (with homogeneity) of cohort studies2b Individual cohort study (including low quality RCT; e.g., <80% follow-up)2c ‘Outcomes’ Research; Ecological studies3a Systematic review (with homogeneity) of case–control studies3b Individual case–control study4 Case series (and poor quality cohort and case-control studies)5 Expert opinion without explicit critical appraisal, or based on physiology, bench research or ‘first principles’Grading of recommendationsA. Based on evidence level 1a, b or c.B. Based on evidence level 2a, b or c, 3a or b.C. Based on evidence level 4 D Based on evidence level 5.