| WHO 2010 | Details | Points |
---|---|---|---|
Recommendation 1 | When to start | - CD4 count < 350 - WHO Clinical stage 3 and 4 irrespective of CD4 count | 2 |
Recommendation 2 | What to start | - AZT+3TC +EFV - AZT+3TC+NVP - TDF+3TC/FTC+EFV - TDF+3TC/FTC+NVP | 4 |
Recommendation 3 | ART for HIV/TB | - Start ART in all patients with TB - Start TB treatment first - Prefer EFV - Start ART within 2-8 weeks of starting TB treatment - If CD4 count < 200, start ART within 2 weeks | 5 |
Recommendation 4 | ART for HIV/Hep B | - Start ART in all patients who require treatment for their Hepatitis B - Start TDF and 3TC/FTC | 2 |
Recommendation 5 | ART for pregnancy | - Start ART in all pregnant women if CD4 count < 350 - Start ART in all women with clinical stage 3 or 4 disease irrespective of CD4 count - AZT preferred in pregnancy - EFV or NVP can be used - Do not start EFV in first trimester | 6 |
Recommendation 6 | When to switch - (note: if VL 5000 or less, will be accepted e.g. 1000) | - VL > 5000copies/mL on at least two occasions - Use CD4 count if VL not available | 2 |
Recommendation 7 | Second line ART (note: if any one of the protease inhibitors included, will accept) | - Boosted PI + 2 NRTIs recommended - Atazanavir/ritonavir or Lopinavir/ritonavir or darunavir/ritonavir recommended - If TDF used in first line, use AZT/D4T next - AND if AZT/D4T used in first line, use TDF in second line | 4 |