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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
Open this folder and view contentsCHAPTER 10: MANAGEMENT OF COMMON SYMPTOMS AND OPPORTUNISTIC INFECTIONS IN HIV/AIDS
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
close this folderCHAPTER 13: ARV THERAPY IN INFANTS AND CHILDREN
View the document13.1 Antiretroviral regimens for HIV infected children
View the document13.2 Goals of Antiretroviral Therapy in children
View the document13.3 Selection of Patients for Antiretroviral Therapy
View the document13.4 Recommended First-Line ARV Regimens in Infants and Children
View the document13.5 Clinical Assessment of Infants and Children Receiving ARV Therapy
close this folder13.6 Reasons for Changing ARV Therapy in Infants and Children
View the document13.6.1 Clinical Conditions
View the document13.6.2 Immunological Conditions
View the document13.6.3 Virological Conditions
View the document13.7 Recommended Second-Line ARV Therapy for 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
 

13.6.2 Immunological Conditions

Immunological conditions indicating that a change to second-line therapy is warranted include:

Persistent decline in CD4 percent over 2 months in absence of TB

Rapid and substantial decrease in absolute CD4 count (i.e. > 30% decline in < 6 months)

Return of CD4 percent to or below pre-therapy baseline

Note: CD4 percent should not be measured during an intercurrent infection; preferably it should be determined 1 month (or more) post-resolution.

If there is a modest decline in CD4 percent (< 5%) and if there is no failure to thrive, do not change medication, but maintain close monitoring.

Despite a good clinical and immunological response, viral resistance will occur in the absence of complete viral suppression. Many experts will delay changing therapy unless there are signs of clinical or immunological progression.

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