South Africa National Department of Health
Publication Date: April 1, 2015
2015 update of the antiretroviral management guidelines from the South Africa National Department of Health, consolidating guidelines for adults, adolescents, infant, children, and for prenatal care. Focus of the new guidelines included increasing effectiveness and efficiency of programmes; managing HIV as a chronic health condition; strengthening integration of services promoting human rights and health equity; promoting a family approach to HIV care; and strengthening the HIV continuum of care.
Topics addressed include HIV counselling and testing including introduction of patients into the continuum of care as well as managing those who test HIV negative (wellness programme); preparation for initiation on antiretroviral therapy (ART); principles of adherence, psychosocial care and support; HIV disclosure; standardised national eligibility criteria for starting ART regimens; standardised national ART regimens; standardised national monitoring for those with HIV; standardised national ART regimens for HIV-positive pregnant women and their infants; labour, delivery, and postnatal care for mothers and infants; ART prophylaxis for HIV-exposed infants; visit scheduling for adults with HIV; first-line therapy for treatment-naive patients; clinical and laboratory monitoring of patients on first-line treatment; adherence support, assessment, and monitoring; when to switch ART regimens; substituting drugs in the first-line regimen; treatment failure; standardised second- line regimens and third-line options for ART; clinical and laboratory monitoring of patients on second-line treatment; management of treatment failure after second-line treatment; management of patients previously treated with ART; treatment interruptions; patients with tuberculosis (TB); patients with hepatitis B virus; patients with anaemia (including during pregnancy and in infants and children); expectations regarding care; diagnosis and management of adverse events; drug-drug interactions with antiretroviral drugs; adverse events; routine patient management; TB screening, prevention, and diagnosis; isoniazid prophylaxis; clinical HIV stage; opportunistic infection diagnosis and management; CD4+ cell count and HIV-1 RNA monitoring; cotrimoxazole prophylaxis; sexually transmitted infection screening; Pap smear; immunizations; family planning; mental health screening; screening for Cryptococcus infection; HIV transmission and reinfection prevention; support provision; and contraindications and special considerations; data collection tools and reporting procedures.
Keywords: HIV - First-line Therapy, HIV - Monitoring, HIV - Paediatric/Adolescent Patients, HIV - Pregnancy, HIV - Resource-Limited Settings, HIV - Treatment-Experienced Patients, HIV - Adherence, HIV - Tuberculosis, HIV - Adverse Events, HIV - Switch Strategies, HIV - Viral Hepatitis Coinfection