Proposed arv regimens

THE SOUTH AFRICAN
ANTIRETROVIRAL TREATMENT
GUIDELINES
The South African Antiretroviral Treatment
Guidelines
Goals of the programme
Achieve best health outcomes in the most cost-efficient Decentralise service delivery to PHC facilities Integrate services for HIV, TB, MCH, SRH and Prevent new infections among children, adolescents, Objectives
To contribute to strengthening of the public and private health sectors’ capacity to deliver high quality To ensure timely initiation of ARVs for treatment and prevention according to the Presidential mandates To minimize unnecessary drug toxicities Specific Objectives
 Patients with CD4 counts < 200cells/mm3 or with severe HIV disease irrespective of CD4  Patients co-infected with TB/HIV  Pregnant women with CD4 < 350cells/mm3 for lifelong ART and CD4 >350cells/mm3 for To test all HIV exposed children under one year and treat all those found to be infected with HIV To standardise first and second line therapy for children, adolescents, and adults in the public and To expand the use of fixed-dose and co-packaged To enable nurses to initiate ARVs for treatment and To enable PHC facilities to initiate, manage, monitor 1. Standardised national eligibility criteria for starting
ART regimens for Adults and Adolescents
Eligible to start ART
 CD4 count <200cells/mm3 irrespective of clinical stage o In patients with TB/HIV o Pregnant women  WHO stage IV irrespective of CD4 count Require fast track (i.e. ART initiation within 2 weeks of
being eligible
 Pregnant women eligible for lifelong ART  Patients with very low CD4 (<100)  Stage 4, CD4 count not yet available Not yet eligible for ART
 Transfer to a wellness programme for regular follow up  Advice on how to avoid HIV transmission to sexual  Initiate INH prophylaxis if asymptomatic for TB  Contraceptives and annual Pap smear 2. Standardised national ART regimens for adults and
adolescents
3. Standardized National Monitoring for Adults and
Adolescents with HIV
At initial Diagnosis of HIV
At Routine Follow-Up Visits
If Eligible for ART
Standardised national eligibility criteria for starting ART
regimens for infants and children
Eligible to Start ART
 All children less than 1 year of age  Children 1 – 5 years with clinical stage 3 or 4 or CD4 ≤ 25 % or Children > 5 years to 15 years with clinical stage 3 or 4 or CD4 < Require Fast-Track (i.e. start ART within 2 weeks of being
eligible)
 Children less than 1 year of age  Stage 4  MDR or XDR-TB 4. Standardised national ART regimens for infants and
children
5. Standardized national monitoring for infants and
children with HIV
At initial Diagnosis of HIV
Document weight and height To monitor growth and development + At Routine Follow-Up
If eligible for ART
6. Standardised national ART and ARV regimens for
women who are HIV positive and pregnant and their
Maternal Regimens
Infant Regimens
any breastfeeding
any breastfeeding
Acronym glossary

Source: http://childrensrightcentre.webhouse.co.za/site/files/6592/Short%20version%20of%20the%20South%20African%20HIV%20care%20and%20treatment%20guidelines.pdf