อัปเดตแนวทางการจัดการ HIV/AIDS จาก WHO 2025–2026 และ Thailand HIV/AIDS Guidelines 2025 — ART, PrEP, PMTCT, TB Prevention
| Parameter | Previous (2021) | Updated (2026) |
|---|---|---|
| Preferred 1st-line | DTG-based + EFV-based options | CONFIRMED DTG-based preferred |
| Protease Inhibitor | ATV/r หรือ LPV/r | NEW DRV/r preferred |
| NRTI Backbone | TDF หรือ ABC แยกตาม history | NEW Reuse TDF/ABC allowed |
| 2-Drug Regimen | DTG/3TC for selected patients | EXPANDED For virally suppressed + HBV-negative |
| LA Injectable ART | CAB/RPV available | RECOMMENDED CAB/RPV as switching option |
Strong evidence: effectiveness, tolerability, high barrier to resistance
Better outcomes & tolerability vs ATV/r or LPV/r
For stable, virally suppressed patients without active HBV
Gilead Sciences · FDA approved June 2025 · WHO recommended at IAS 2025
ViiV Healthcare · Every 2 months injection
Improved uptake & completion rate vs longer regimens
Shorter regimen → better completion → reduced TB-related mortality in PLWH
| Comorbidity | WHO 2025 Recommendation | Epidemiology |
|---|---|---|
| Depression | Screen & integrate mental health into HIV services | 1 in 3 PLWH globally |
| Anxiety | Integrate anxiety screening into routine visits | 1 in 3 PLWH globally |
| Suicide Ideation | Mental health assessment as part of HIV care | 1 in 4 PLWH globally |
| Diabetes | Integrate diabetes screening & management | 1 in 10 PLWH in Africa |
| Hypertension | Blood pressure monitoring at every visit | 1 in 4 PLWH in Africa |
| Mpox (if diagnosed) | Start/improve ART immediately (<7 days, ideally same day) | Higher risk of severe mpox in advanced HIV |
| STIs (Gonorrhea/Chlamydia) | Routine screening in high-prevalence settings, MSM, sex workers, pregnant | Annual or twice-yearly depending on risk |