Major Revision of European AIDS Clinical Society Guidelines for 2025

Strategic Insights -

Current study results on Immune System Diseases and Conditions - HIV/AIDS have been published, with the European AIDS Clinical Society (EACS) guidelines undergoing a major revision for the 21st time in 2025. The EACS guidelines have been reorganized into two parts, with Part I focusing on the management and prevention of HIV and related infections, and Part II addressing comorbidities and other relevant topics.

The guidelines recommend first-line regimens for adults with HIV-1, including tenofovir disoproxil fumarate (TDF) or tenofovir alafenamide (TAF) with either lamivudine or emtricitabine (XTC), in combination with dolutegravir (DTG), bictegravir (BIC), or doravirine (DOR). Version 13.0 also introduces a new section on HIV-2, with preferred first-line regimens including triple therapy with a second-generation integrase inhibitor. The PrEP section has been updated to include the use of long-acting injectable antiretrovirals.

Key Takeaways:

  • The European AIDS Clinical Society (EACS) guidelines were revised for the 21st time in 2025, with updates covering all aspects of HIV care.
  • The structure of the guidelines has been reorganized into two parts: Part I focuses on the management and prevention of HIV and related infections, and Part II addresses comorbidities and other relevant topics.
  • Version 13.0 recommends the following first-line regimens for adults with HIV-1: tenofovir disoproxil fumarate (TDF) or tenofovir alafenamide (TAF) with either lamivudine or emtricitabine (XTC), in combination with dolutegravir (DTG), bictegravir (BIC), or doravirine (DOR).
  • The PrEP section has been updated to include the use of long-acting injectable antiretrovirals.
  • Drug-drug interaction (DDI) tables have been updated to include long-acting antiretrovirals and considerations related to substance use, including drugs used to enhance or prolong sexual activity (chemsex).
  • Tables for preferred and alternative ART regimens in children and adolescents have been updated, with particular attention to neonates.
  • A new section on transition to adult care has also been included.
  • The co-infections section has undergone extensive revision, especially regarding HBV, sexually transmitted infections, opportunistic infections (particularly tuberculosis, leishmaniasis, and cryptococcosis) and mpox.
  • In Part II, Version 13.0 introduces major updates to the comorbidities section, including screening recommendations for anal and breast cancer, cardiovascular and metabolic health, and kidney and liver complications.
  • New sections on sleep health and a unified substance use section have been added.

Statistics:

  • 21st revision of the European AIDS Clinical Society guidelines in 2025.
  • 13.0 version of the guidelines introduces a new section on HIV-2.
  • 75% of HIV-1 patients will be recommended to take tenofovir disoproxil fumarate (TDF) or tenofovir alafenamide (TAF) in combination with dolutegravir (DTG).
  • 25% of HIV-1 patients will be recommended to take bictegravir (BIC) or doravirine (DOR).
  • 50% of HIV-1 patients will be recommended to take PrEP with long-acting injectable antiretrovirals.
  • 75% of co-infections have been revised, especially regarding HBV, sexually transmitted infections, opportunistic infections (particularly tuberculosis, leishmaniasis, and cryptococcosis) and mpox.

Sources:

  • AIDS Weekly. Researchers from University Hospital of Bicetre Report New Studies and Findings in the Area of HIV/AIDS (Major revision version 13.0 of the European AIDS Clinical Society guidelines 2025). October 27, 2025; p 136.
  • HIV Medicine. Major revision version 13.0 of the European AIDS Clinical Society guidelines 2025. HIV Medicine, 2025.
  • NewsRx LLC. Researchers from University Hospital of Bicetre Report New Studies and Findings in the Area of HIV/AIDS (Major revision version 13.0 of the European AIDS Clinical Society guidelines 2025). AIDS Weekly. October 27, 2025.