Grade C evidence means low-quality evidence from controlled trials with several very serious limitations or observational studies with limited evidence on effects and exclusion of most potential sources of bias. Grade D evidence on the other hand is based only on case studies, expert judgement or observational studies with inconsistent effects and a potential for substantial bias, such that there is likely to be little confidence in the effect estimate. In addition to graded recommendations, the BHIVA Writing Group has also included good practice points (GPP), which are recommendations PD-0332991 clinical trial based on the clinical judgement and experience of the working

group. GPPs emphasize an area of important clinical practice for which there is not, nor is there likely to be, any significant research evidence. They address an aspect of treatment and care that is regarded as such sound clinical practice that healthcare professionals are unlikely to check details question it and where the alternative recommendation is deemed unacceptable. It must be emphasized that

GPPs are not an alternative to evidence-based recommendations. The following measures have/will be undertaken to disseminate and aid implementation of the guidelines: E-publication on the BHIVA website and the journal HIV Medicine. Publication in HIV Medicine. Shortened version detailing concise summary of recommendations. E-learning module accredited for CME. Educational slide set to support local and regional educational meetings. National BHIVA audit programme. The 3-mercaptopyruvate sulfurtransferase guidelines will be next fully updated and revised in 2014. However, the

Writing Group will continue to meet regularly to consider new information from high-quality studies and publish amendments and addendums to the current recommendations before the full revision date where this is thought to be clinically important to ensure continued best clinical practice. The primary aim of ART is the prevention of the mortality and morbidity associated with chronic HIV infection at low cost of drug toxicity. Treatment should improve the physical and psychological well-being of people living with HIV infection. The effectiveness and tolerability of ART has improved significantly over the last 15 years. The overwhelming majority of patients attending HIV services in the UK and receiving ART experience long-term virological suppression and good treatment outcomes [5], which compare very favourably with other developed countries. Recent data have shown that life expectancy in the UK of someone living with HIV infection has improved significantly over recent years but is still about 13 years less than that of the UK population as a whole [6].