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close this bookNational Guidelines for the Clinical Management of HIV/AIDS - Tanzania (NACP; 2005; 131 pages)
View the documentLIST OF ABBREVIATIONS
View the documentACKNOWLEDGEMENTS
View the documentFOREWORD
Open this folder and view contentsCHAPTER 1: INTRODUCTION
Open this folder and view contentsCHAPTER 2: ORGANIZATION OF HIV/AIDS CARE AND TREATMENT
Open this folder and view contentsCHAPTER 3: HIV/AIDS PREVENTION
Open this folder and view contentsCHAPTER 4: PROTECTIVE MEASURES AGAINST HIV TRANSMISSION
Open this folder and view contentsCHAPTER 5: LABORATORY TESTS IN HIV/AIDS
Open this folder and view contentsCHAPTER 6: HIV/AIDS AND PREGNANCY
Open this folder and view contentsCHAPTER 7: PEDIATRIC HIV/AIDS AND RELATED CONDITIONS
Open this folder and view contentsCHAPTER 8: COMMUNITY AND HOME BASED CARE FOR PEOPLE LIVING WITH HIV/AIDS (PLHA)
Open this folder and view contentsCHAPTER 9: COUNSELLING RELATED TO HIV-TESTING AND TREATMENT ADHERENCE
close this folderCHAPTER 10: MANAGEMENT OF COMMON SYMPTOMS AND OPPORTUNISTIC INFECTIONS IN HIV/AIDS
View the document10.1 Introduction
Open this folder and view contents10.2 Clinical features commonly encountered in patients with HIV/AIDS
close this folder10.3 Prophylactic treatment of common opportunistic infections in HIV/AIDS
View the document10.3.1 Prophylactic treatment using Co-trimoxazole
View the document10.3.2 Preventive therapy against TB in PLHAs
Open this folder and view contents10.4 Treatment of Opportunistic Infections:
Open this folder and view contentsCHAPTER 11: MANAGEMENT OF MENTAL HEALTH PROBLEMS IN HIV/AIDS
Open this folder and view contentsCHAPTER 12: MANAGEMENT OF HIV INFECTED PATIENTS USING ANTIRETROVIRAL DRUGS
Open this folder and view contentsCHAPTER 13: ARV THERAPY IN INFANTS AND CHILDREN
Open this folder and view contentsCHAPTER 14: USE OF ARVS IN SPECIAL CIRCUMSTANCES
Open this folder and view contentsCHAPTER 15: HIV/AIDS AND NUTRITION
Open this folder and view contentsCHAPTER 16: MANAGEMENT OF ANTIRETROVIRAL MEDICINES
Open this folder and view contentsCHAPTER 17: CERTIFICATION OF HEALTHCARE FACILITIES AS CARE AND TREATMENT SITES
 

10.3.1 Prophylactic treatment using Co-trimoxazole

Indications

In HIV/AIDS patients, starting with WHO Stage 3 (see Chapter 11 for staging criteria)

All adult persons with symptomatic HIV disease including all symptomatic pregnant women after the first trimester and before 37 weeks of pregnancy.

All children born to HIV positive women from six weeks of age and those identified, as being HIV positive within the first year of life until proven HIV negative or intolerant to Co-trimoxazole or have a CD4 count > 15%

Children older than 12 months who have symptomatic HIV disease or CD4 < 15%.

Asymptomatic HIV infected individuals with CD4 counts <200 cells/ml

It should be noted that baseline LFT and RFT are required before long term administration of Co-trimoxazole

Dose:

Adults - One double strength tablet (160/800 mg) or two single strength tablets once a day on a daily basis. For those with < 60kg, see ARV dosing chart, which includes Co-trimoxazole dosing,

Children - Co-trimoxazole: see paediatric dosing chart.

Duration:

Prophylaxis is for life for both adults and children who are not on ARVs.

For those on ARV’s, co-trimoxazole prophylaxis can be stopped if CD4 is >200

Children who are born to HIV infected women can stop prophylaxis when HIV infection has been reasonably ruled out and the risk of exposure has ceased.

Children older than 18 months can continue with the prophylaxis only if the diagnosis of HIV infection has been confirmed by serology

Criteria for stopping

Occurrence of severe side effects such as severe cutaneous reactions, or such as fixed drug reactions

If ART is initiated and CD4 count is above 200 cells/ml in adults or above 15% in children

Renal and/or hepatic insufficiency or severe haematological toxicity if anti retroviral agents are used

Follow up

Regular follow up initially every month for the first three months, then every three months if the medication is well tolerated.

It is mandatory to monitor for side effects and adherence. Monitoring includes assessment of skin reactions, measurements of haemoglobin, and white blood counts every six months and when clinically indicated.

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