Antiretroviral Guidelines

US DHHS Guidelines with Australian commentary


Initiation of Antiretroviral Therapy


Last Updated: December 18, 2019; Last Reviewed: December 18, 2019

Panel's Recommendations for Initiating Antiretroviral Therapy in Treatment-Naive Patients

AU comment: When to start

AU comment: Treatment as prevention

AU comment: Immediate initiation

Panel’s Recommendations


  • Antiretroviral therapy (ART) is recommended for all persons with HIV to reduce morbidity and mortality (AI) and to prevent the transmission of HIV to others (AI).
  • The Panel on Antiretroviral Guidelines for Adults and Adolescents recommends initiating ART immediately (or as soon as possible) after HIV diagnosis in order to increase the uptake of ART and linkage to care, decrease the time to viral suppression for individual patients, and improve the rate of virologic suppression among persons with HIV (AII).
  • When initiating ART, it is important to educate patients regarding the benefits of ART and to deploy strategies to optimize care engagement and treatment adherence (AIII).
Rating of Recommendations: A = Strong; B = Moderate; C = Optional
Rating of Evidence: I = Data from randomized controlled trials; II = Data from well-designed nonrandomized trials or observational cohort studies with long-term clinical outcomes; III = Expert opinion