Guidelines to Antiretroviral Drug Therapy in Kenya: ACKNOWLEDGMENT

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	Guidelines to Antiretroviral Drug Therapy in Kenya (WHO; 2001; 78 pages)
		FOREWORD
		ACKNOWLEDGMENT
		CHAPTER ONE: INITIATING ANTIRETROVIRAL THERAPY
			1.1 Introduction
			1.2 Guidelines to making a diagnosis of HIV infection
			1.3 Laboratory Diagnosis of HIV infection
			1.4 Goals of therapy
			1.5 When to start therapy
			1.6 Risks and benefits of delayed initiation of therapy and of early therapy in the Asymptomatic HIV-Infected Patient
			1.7 Antiretroviral profile
			1.8 What drug combination to start with?
		CHAPTER TWO: MONITORING AND CHANGING THERAPY
			2.1 Surrogate markers
			2.2 Resistance testing
			2.3 How often should CD4 Cell Count and Viral Load be performed (Frequency)
			2.4 Treatment failure
			2.5 Reasons for non-adherence
			2.6 Considerations for changing a failing regimen
			2.7 Guidelines for changing an antiretroviral regimen for suspected drug failure
			2.8 Potential options for changing therapy*
		CHAPTER THREE: PHARMACOTHERAPEUTICS OF ARVS
			3.1 Characteristics of available antiretroviral drugs
			3.2 Pharmacokinetic properties of Antiretrovirals
		CHAPTER FOUR: GUIDELINES FOR THE USE OF ANTIRETROVIRAL DRUGS IN PAEDIATRIC HIV INFECTION
			4.1 Overview
			4.2 Diagnosis of HIV infection in children
			4.3 When to initiate treatment
			4.4 Initiation of treatment
			4.5 Agents to choose for initial treatment
			4.6 Dosages for paediatric formulations
			4.8 Monitoring
			4.9 When to change therapy
		CHAPTER FIVE: MANAGEMENT OF HUMAN IMMUNODEFICIENCY VIRUS (HIV) INFECTED PREGNANT WOMEN AND PREVENTION OF MOTHER TO CHILD TRANSMISSION (MTCT) OF HIV
			5.1 Overview
			5.2 Factors affecting mother to child transmission
			5.3 Outline antenatal, intrapartum postpartum and postnatal care
			5.4 Antiretroviral Therapy to prevent MTCT
		CHAPTER SIX: SPECIAL CONSIDERATIONS
			6.1 Acute retroviral syndrome (ARVS)
			6.2 ARV drugs and the treatment of Tuberculosis
			6.3 Immune recovery syndrome
		CHAPTER SEVEN: WHEN TO STOP TREATMENT (INTERRUPTIONS)
			7.1 Structured treatment interruptions (STI's)
			7.2 Non structured treatment interruption
		CHAPTER EIGHT: GUIDELINES FOR POST EXPOSURE PROPHYLAXIS
			8.1 Treatment of exposure sites
			8.2 Timing of post - HIV exposure prophylaxis initiation
			8.3 Assessment of exposure risk
			8.4 Post - HIV exposure prophylaxis
			8.5 Recommended HIV serology after exposure
			8.6 Management of health care workers with accidental exposure to HIV infection
			8.7 Management of hospital staff with sharp injury or exposure to blood and body fluids
			8.8 Management of non occupational exposure to HIV infection
			8.9 Management of non-sexual and non occupational Exposures to HIV
		CHAPTER NINE: ACCESS TO DRUGS IN KENYA
		APPENDICES
			I. Drug to drug interactions
			II. Drug to drug interactions (continued)
			III. Drug Interactions Between Antiretrovirals and Other Drugs
			IV. Nucleoside Reverse Transcriptase Inhibitors (NRTIS)
			V. Drug Interactions: Protease Inhibitors
			VI. Drug Interactions: Protease Inhibitors and Non-Nucleoside Reverse Transcriptase Inhibitors - Cont.
			VII. Drug That Should Not be Used With Antiretrovirals
			VIII. Drugs that should not be used with Protease Inhibitors Antiretrovirals
			IX. HIV-related drugs with overlapping toxicities
			X. Anti-retroviral therapy for preventing MTCT
		BACK COVER

ACKNOWLEDGMENT

These guidelines are a result of the collaborative effort of many people, whose dedication and hard work is gratefully acknowledged.

The alphabetical list of the main contributors are given below.

Dr. Aluoch A.	-	Kenya Association of Physicians
Dr. Anzala O.	-	University of Nairobi
Prof. Bhatt K.M.	-	University of Nairobi
Dr. Chebet K.L.	-	NASCOP - Ministry of Health
Dr. Hardika Shah	-	Nairobi Hospital
Dr. Ilako, F	-	Kenya Association of Physicians
Dr. Karanja Joseph	-	University of Nairobi
Dr. Kevin De-Cock	-	CDC - Director (Kenya)
Prof. Kokwaro, Gilbert	-	Wellcome Trust
Dr. Koskei K.	-	Chief Pharmacist - Ministry of Health
Prof. Lule G.N.	-	University of Nairobi
Dr. Lwanga Charles	-	Nairobi Hospital
Prof. Mati J.K.G	-	KOGS
Dr. D. Mbori Ngacha	-	University of Nairobi
Dr. Mohammed I.M.	-	NASCOP - Ministry of Health
Dr. Mugo Nelly	-	Kenyatta National Hospital
Dr. Muita Jane	-	UNICEF
Dr. Mulindi Sobbie	-	University of Nairobi
Prof. Musoke Rachel	-	University of Nairobi
Dr. Mutungi Alice	-	University of Nairobi
Dr. Mwangi Margaret	-	Kenyatta University Hospital
Dr. Nduati Ruth	-	University of Nairobi
Dr. Ochiel Stephen	-	KOGS
Prof. Ojwang S.B.O.	-	University of Nairobi
Dr. Ombuya Godfrey	-	Kenyatta National Hospital
Dr. Omondi Ogutu	-	Kenyatta National Hospital
Prof. Otieno L.S.	-	University of Nairobi
Dr. Owili D.	-	Aga Khan Hospital
Dr. P. Muia Ndavi	-	KOGS
Dr. Patel S.T.	-	MP Shah
Dr. Qureshi Zahinda	-	University of Nairobi
Dr. Shah Sital	-	Aga Khan Hospital
Dr. Tesfaldet G.	-	Aga Khan Hospital
Dr. Wairagu S.E.	-	Kenyatta National Hospital
Dr. Were Edwin	-	Moi University

The Director of Medical Services, Dr. Richard Muga, and Director -NASCOP Dr. Kenneth Chebet facilitated the harmonization of the various guidelines into one.

Further appreciation goes to Dr. M.S. Abdallah, Chairman, and Dr. M. Gachara, Director, National AIDS Control Council for their support to this project.

The Ministry of Health gratefully acknowledges the financial assistance from joint United Nations Programme on HIV/AIDS (UNAIDS) and WHO which facilitated the writing, editing, printing and implementation of the guidelines. A special appreciation is extended to Dr. Warren Naamara (UNAIDS), Dr. Marinus Gotink (UNICEF) Dr. Peter Eriki (WHO) and Mr. Andrew Stenton (Nairobi Hospital) for their invaluable contribution.

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