Dr J Dhar has received conference support from ViiV. Mrs K Gandhi has no conflicts of interest to declare.

Dr Y Gilleece has received lecture and consultancy fees from ViiV. Dr K Harding has received lecture and consultancy fees from ViiV. Dr D Hawkins has no conflicts of interest to declare. Dr P Hay has received lecture and consultancy fees from Abbott, Boehringer-Ingelheim, Bristol-Myers Squibb, Gilead, Johnson and Johnson (Tibotec) and ViiV. He has received conference support from Bristol-Myers Squibb, Gilead and Janssen and his department has received research grant support from Abbott, Boehringer Ingelheim, Gilead, Janssen and ViiV. Ms J Kennedy has no conflicts of interest to declare. Dr N Low-Beer has no conflicts selleck products click here of interest to declare. Dr H Lyall has received lecture fees from Danone and ViiV. Dr F Lyons has no conflicts of interest to declare. Dr D Mercey has no conflicts of interest to declare. Dr P Tookey has received research grant support from AbbVie. Dr S Welch has no conflicts of interest to declare. Dr E Wilkins

has received lecture and consultancy fees from Bristol-Myers Squibb, Gilead, Janssen, Merck Sharp and Dohme and ViiV. BHIVA revised and updated the Association’s guideline development manual in 2011 [364]. BHIVA has adopted the modified Grading of Recommendations Assessment, Development and Evaluation (GRADE) system for the assessment, evaluation and grading of evidence and the development of recommendations [365, 366]. only 1A Strong recommendation. High-quality evidence. Benefits clearly outweigh risk and burdens, or vice versa. Consistent evidence from well-performed, randomized, controlled trials or overwhelming evidence of some other form. Further research is unlikely to change our confidence in the estimate of benefit and risk. Strong recommendations, can apply to most patients in most circumstances without reservation.

Clinicians should follow a strong recommendation unless there is a clear rationale for an alternative approach. 1B Strong recommendation. Moderate-quality evidence. Benefits clearly outweigh risk and burdens, or vice versa. Evidence from randomized, controlled trials with important limitations (inconsistent results, methods flaws, indirect or imprecise), or very strong evidence of some other research design. Further research may impact on our confidence in the estimate of benefit and risk. Strong recommendation and applies to most patients. Clinicians should follow a strong recommendation unless a clear and compelling rationale for an alternative approach is present. 1C Strong recommendation. Low-quality evidence. Benefits appear to outweigh risk and burdens, or vice versa. Evidence from observational studies, unsystematic clinical experience, or from randomized, controlled trials with serious flaws. Any estimate of effect is uncertain. Strong recommendation, and applies to most patients.