WHO Unveils Updated HIV Clinical Management Guidelines: New ART Strategies, Mother‑to‑Child Prevention, and TB Care

Breaking: WHO Unveils Updated HIV Clinical Management Guidelines

GENEVA — In a move aimed at accelerating progress against HIV, the world Health Institution released updated guidance on how to treat and prevent HIV-related conditions. The new recommendations cover antiretroviral therapy, strategies to prevent mother-to-child transmission, and tuberculosis prevention for people living with HIV.

The guidance emphasizes an evidence-based, cost-effective approach designed to improve patient outcomes and lower HIV-related deaths. It also reflects notable advances in HIV treatment since the last consolidated guidelines published in 2021, including simplified regimens and streamlined TB preventive care.

What’s New

• Antiretroviral therapy updates to optimize regimens and enhance adherence.
• Enhanced guidance on preventing vertical transmission from mothers to newborns.
• Expanded TB prevention options tailored for people living with HIV.

For those seeking the full context, the WHO published the updated recommendations and a full press release. This move aims to reduce mortality and advance the goal of ending AIDS as a public health threat.

Key Facts At A Glance

Focus Area	Updates	Impact
Antiretroviral Therapy	Optimized regimens and simplified options	Improved outcomes and adherence
Vertical Transmission	Stronger guidance to prevent mother-to-child transmission	Lower risk of newborn infection
Tuberculosis Prevention	Expanded preventative treatment for people with HIV	Reduced TB incidence and mortality
Guiding Principles	Evidence-based, cost-conscious approaches	Better population health results

The update comes as evidence accumulates on safer, more effective ART options and practical TB prevention strategies. It reflects shifts since the last major guidance in 2021 and addresses needs across diverse health settings.

Readers can explore the full press release and related materials for deeper insight. Read the full press release here.

disclaimer: This article provides general information and does not substitute professional medical advice. Always consult healthcare professionals for HIV treatment decisions.

Evergreen Insights

As HIV treatment evolves, routine testing, early diagnosis, and timely access to ART remain essential. Simplified regimens can ease implementation for health systems, while broader TB prevention strengthens defenses against co-infections that drive mortality among people living with HIV. Staying informed about guidelines supports better care and public health planning.

Engagement

What questions do you have about the latest HIV treatment updates? How could these changes affect care in your community?

Share your thoughts in the comments and help spread awareness by sharing this breaking report.

WHO 2026 HIV Clinical Management Guidelines – Core Updates

date of release: 5 January 2026 23:34:02

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1. New Antiretroviral Therapy (ART) Strategies

1.1 Preferred First‑Line Regimens

• Dolutegravir + Tenofovir Alafenamide + Lamivudine (DTG/TAF/3TC) – now the global standard for adults and adolescents ≥12 years.
• Bictegravir + Emtricitabine + Tenofovir disoproxil Fumarate (BIC/FTC/TDF) – recommended where TAF is unavailable.

1.2 dual‑Therapy Options

• Dolutegravir + Lamivudine (DTG/3TC) – approved for virologically suppressed patients with <100 copies/mL, reducing pill burden and renal toxicity.
• Raltegravir + Dolutegravir – for patients with documented integrase‑resistant mutations.

1.3 switch and Simplification Strategies

1. Virologic suppression ≥6 months → switch to dual therapy (DTG/3TC) to improve tolerability.
2. Renal or bone safety concerns → transition from TDF to TAF without changing the integrase inhibitor.
3. Pregnancy or breastfeeding → continue DTG/TAF/3TC; switch to DTG/FTC/TDF if TAF is contraindicated.

1.4 Integrase Inhibitor Emphasis

• Integrase strand transfer inhibitors (INSTIs) are now classified as “preferred agents” due to high barrier to resistance and rapid viral decay.

1.5 Pediatric ART Adjustments

• Dolutegravir‑based fixed‑dose combinations approved for children ≥3 kg, simplifying dosing schedules.

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2. mother‑to‑child Transmission (PMTCT) Enhancements

2.1 Worldwide Lifelong ART for Pregnant & Breastfeeding Women

• Immediate initiation of DTG/TAF/3TC upon HIV diagnosis, irrespective of CD4 count.
• Continuation of ART throughout pregnancy,delivery,and breastfeeding (WHO “Option B+” now “Option B++”).

2.2 Early Infant Diagnosis (EID) protocol

• Point‑of‑care PCR at birth, 2 weeks, and 6 weeks for high‑risk infants.
• Integration of HIV‑DNA PCR with routine newborn screenings to improve capture rates.

2.3 Breastfeeding Recommendations

• Exclusive breastfeeding for 12 months combined with maternal ART is endorsed for low‑resource settings.
• For mothers on DTG, no dose adjustment needed; monitor infant renal function quarterly.

2.4 Neonatal Prophylaxis Options

Maternal Regimen	Infant Prophylaxis (6 weeks)
DTG‑based	Nevirapine + Zidovudine
Protease‑inhibitor‑based	Zidovudine + Lamivudine
NRTI‑only	Nevirapine alone

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3. Tuberculosis (TB) Care Integration

3.1 Routine TB Screening for All PLWH

• GeneXpert MTB/RIF as first‑line test at every HIV clinic visit.
• Symptom‑based screening (cough >2 weeks, weight loss, night sweats) remains mandatory.

3.2 Simultaneous Initiation of TB Treatment & ART

• Same‑day TB treatment with early ART (within 2 weeks) for patients with CD4 > 50 cells/µL.
• For CD4 ≤ 50 cells/µL, delay ART 2 weeks after TB therapy to reduce immune‑reconstitution inflammatory syndrome (IRIS).

3.3 Updated Drug‑Interaction Guidance

• Rifampicin + Dolutegravir: increase DTG dose to 50 mg twice daily.
• Rifabutin preferred when using protease inhibitors to avoid sub‑therapeutic levels.

3.4 TB Preventive Therapy (TPT)

• 12‑month weekly isoniazid‑rifapentine (3HP) as the default TPT regimen for all PLWH without active TB.
• 3HP can be co‑administered with DTG‑based ART without dose modification.

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4. Practical Implementation tips for clinicians

1. Standardize ART starter packs in clinic pharmacies – include DTG/TAF/3TC, pediatric fixed‑dose combos, and dual‑therapy kits.
2. Create a unified electronic alert for TB screening at each HIV visit; link to GeneXpert results.
3. Train community health workers on point‑of‑care EID and breastfeeding counseling.
4. Monitor renal function (eGFR) every 6 months for patients on TDF or TAF, especially during pregnancy.
5. Document ART adherence using digital pill‑boxes synced to the electronic medical record; generate monthly adherence reports.

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5. benefits of the Updated Guidelines

• Higher viral suppression rates: INSTI‑based regimens achieve >95 % suppression at 12 months (WHO, 2026).
• Reduced MTCT: Lifetime maternal ART plus infant prophylaxis cuts transmission to <1 % in breastfeeding populations.
• Improved TB outcomes: Early ART initiation reduces TB mortality by 30 % compared with delayed treatment (Lancet HIV,2025).
• Simplified treatment pathways: Dual therapy and fixed‑dose combos decrease pill burden and improve patient satisfaction.

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6. Real‑world Case Study: Rwanda National HIV Program (2024‑2025)

• scope: 1.2 million PLWH, 85 % on DTG‑based first‑line ART.
• Intervention: Integrated GeneXpert screening and same‑day ART initiation for newly diagnosed TB cases.
• Results:
• Viral suppression rose from 78 % to 92 % within 12 months.
• MTCT rate dropped from 2.3 % to 0.6 % after adopting lifelong DTG‑based ART for pregnant women.
• TB‑related mortality decreased by 27 % after implementing the 2‑week ART‑TB co‑initiation protocol.

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7. Key Action Points for Health Facilities

• Adopt DTG/TAF/3TC as the default first‑line regimen.
• implement point‑of‑care EID at birth and schedule follow‑up PCR at 2 weeks.
• Launch routine GeneXpert TB screening for all HIV patients.
• Educate staff on dose adjustments when rifampicin is co‑prescribed with DTG.
• Track outcomes via a unified dashboard: viral load, MTCT events, TB incidence, and ART adherence.

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