The guidelines are aimed at clinical professionals directly involved with, and responsible for, the care of pregnant women with HIV infection. The British HIV Association (BHIVA) revised and updated the Association’s guideline development manual in 2011 (www.bhiva.org/GuidelineDevelopmentManual.aspx; see also Appendix 1). BHIVA has adopted the modified GRADE system selleck products for the assessment,

evaluation and grading of evidence and the development of recommendations. Full details of the guideline development process including selection of the Writing Group and the conflict of interest policy are outlined in the manual. The guidelines were commissioned by the BHIVA Guidelines INCB024360 Subcommittee who nominated the Chair of the Writing Group and deputy. They then nominated a Writing

Group of experts in the field based on their knowledge, expertise and freedom from conflicts of interest. The scope, purpose and guideline topics were agreed by the Writing Group. Questions concerning each guideline topic were drafted and a systematic literature review undertaken by an information scientist. Details of the search questions and strategy (including the definition of populations, interventions and outcomes) are outlined in Appendices 2 and 3. The literature searches for the 2012 guidelines covered the period up until September 2011 and included abstracts from selected conferences. For each topic and healthcare question, evidence was identified and evaluated by Writing Group from members with expertise in the field. Using the modified GRADE system (see Appendix 1), members were responsible for assessing and grading the quality of evidence for predefined outcomes across studies and developing and grading the strength of recommendations. All Writing Group members received training in use of the modified GRADE criteria before assessing the evidence. Owing to the lack of data from randomized controlled trials (RCTs) in several important areas the Writing Group were unable to assign

high grades (in areas such as mode of delivery); however, they have made recommendations on best practice where decisions need to be made on the balance of available evidence. Recommendations are summarized and numbered sequentially within the text. The guidelines were published online for public consultation and external peer review was commissioned, comments from which resulted in minor revision before final approval by the Writing Group. BHIVA views the involvement of patient and community representatives in the guideline development process as both important and essential. The Writing Group included a patient representative who was involved in all aspects of guideline development.