WHO updated recommendations on HIV clinical management: recommendations for a public health approach: web annex: supporting information

This web annex provides supporting evidence for WHO recommendations on HIV clinical management, compiling systematic review abstracts, GRADE evidence profiles and additional materials to inform guideline development and ensure transparency.

It synthesizes evidence across key areas of HIV care, including optimization of antiretroviral therapy (ART), second-line treatment strategies, dual-therapy regimens (oral and injectable), prevention of vertical HIV transmission, breastfeeding support and tuberculosis preventive treatment in people living with HIV. Dolutegravir-based regimens remain highly effective for second-line therapy, while selected dual-drug regimens show comparable efficacy in specific populations. Long-acting injectable therapies demonstrate similar virological outcomes but raise concerns regarding resistance and adverse events.

Evidence highlights the effectiveness of infant antiretroviral prophylaxis in reducing vertical transmission, with risk closely associated with maternal viral load. Tuberculosis preventive regimens containing rifapentine show higher completion rates and acceptable safety profiles.

Overall, the annex supports evidence-based, patient-centred and context-specific decision-making, while emphasizing gaps in evidence and the need for further research.