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Transcript
Internal Medicine
What does HAART require to be effective?
•
Strict adherence to this regimen
•
Proper monitoring of side effects and disease progression
•
Recognition and treatment of co-morbidities
•
Recognition of drug interactions
The Baseline Assessment before initiation of HAART
™ Baseline medical history
™ Physical examination
™ Clinical staging
™ Laboratory testing
™ Development of the patient care plan
WHO Criteria to Initiate ART in Adults and adolescents
WHO
clinical
CD4 testing not available
CD4 testing available
stage
Start ART only
if CD4
count is < 200/mm3
1
Don’t treat
2
ART may be started if TLC is <
1200/mm3
Start ART if CD4 is<
3
If symptomatic initiate ART
350/mm3
irrespective of TLC
before
and
initiate
CD4
drops
<200/mm3
Start ART irrespective of TLC
Start ART irrespective of
CD4 count
4
Note: ART should be initiated in WHO clinical stage 3 patients with CD4 <350/mm3 if patients
have:
o
Pulmonary TB
o
Sever bacterial infections
127