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When to Initiate ART in Adults and Adolescents (2009 WHO Guidelines)

Explore WHO 2009 guidelines for initiating ART, choosing regimens, and monitoring in high-risk patients. Learn ART recommendations for women with prior MTCT exposure and preferred 2nd-line options.

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When to Initiate ART in Adults and Adolescents (2009 WHO Guidelines)

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  1. When to Initiate ART in Adults and Adolescents (2009 WHO Guidelines)

  2. Preferred 1st Line ART in Adults and Adolescents (2009 WHO Guidelines)

  3. Choice of ART regimen for HIV+ women with prior exposure to MTCT regimens

  4. ART laboratory monitoring 1 Recommended test in patients with high risk of adverse events associated with AZT (low CD4 or low BMI). 2 Recommended test in patients with high risk of adverse events associated with TDF (underlying renal disease, older age group, low BMI, diabetes, hypertension and concomitant use of a boosted PI or nephrotoxic drugs). 3 Recommended test in patients with high risk of adverse events associated with NVP ( ART naive HIV+ women with CD4 > 250 cells/mm3, HCV co-infection)

  5. * Situations where the ARV drug should be avoided or used with close clinical and/or laboratory monitoring.

  6. d4T phase out plan towards AZT or TDF is recommended in settings where d4T regimens are used as the principal option to start ART. • ART should be initiated as soon as possible in all HIV/TB coinfected patients with active TB (within 8 weeks after start TB treatment).

  7. Preferred 2nd Line ART in Adults and Adolescents (2009 WHO Guidelines) 1 ABC and ddI can be considered as backup options in case of toxicity or contraindication to AZT or TDF. 2 LPV 400 mg + RTV 400 mg or SQV 400 mg + RTV 400 mg

  8. * LPV 400 mg + RTV 400 mg or SQV 400 mg + RTV 400 mg

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