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	National Guidelines for the Clinical Management of HIV/AIDS - Tanzania (NACP; 2005; 131 pages)
		LIST OF ABBREVIATIONS
		ACKNOWLEDGEMENTS
		FOREWORD
		CHAPTER 1: INTRODUCTION
			1.1 Epidemiology of HIV/AIDS
			1.2 Impact of HIV/AIDS
				1.2.1 Health Impact
				1.2.2 Economic Impact
				1.2.3 Social impact
			1.3 HIV Transmission
			1.4 Pathophysiology of HIV infection
			1.5 Natural history of HIV infection
			1.6 Progression of HIV infection (see WHO clinical staging criteria in Appendix 1 & 2)
				1.6.1 Primary infection or becoming HIV infected
				1.6.2 Clinically asymptomatic stage
				1.6.3 Symptomatic HIV
				1.6.4 AIDS
		CHAPTER 2: ORGANIZATION OF HIV/AIDS CARE AND TREATMENT
			2.1 Overview
			2.2 Serostatus Determination
			2.3 Scope of Care and Treatment
			2.4 Care and Treatment for those on Antiretroviral Therapy (ART)
				2.4.1 Patient Visits Plan
				2.4.2 Adherence management and lifestyle counselling
				2.4.3 Medical Records System
			2.5 Linkages
				2.5.1 PMTCT Programmes
				2.5.2 Antenatal Clinics
				2.5.3 VCT Programmes
				2.5.4 STI Services
				2.5.5 NTLP Clinics
				2.5.6 Community Based Programmes
		CHAPTER 3: HIV/AIDS PREVENTION
			3.1 Introduction
			3.2 Treatment and Prevention of STIs
			3.3 Prevention of Mother to Child Transmission
			3.4 Condom Programming
			3.5 Workplace Policy and Programme for the Health Sector on HIV/AIDS
			3.6 Prevention of HIV transmission through blood transfusion
			3.7 HIV/AIDS Prevention for Sex Workers and other vulnerable groups
			3.8 The Youth (in and out of school) and HIV/AIDS
			3.9 Voluntary Counselling and Testing (VCT)
			3.10 Reduction of stigma and discrimination
		CHAPTER 4: PROTECTIVE MEASURES AGAINST HIV TRANSMISSION
			4.1 Prevention of nosocomial HIV transmission
			4.2 Prevention of HIV transmission through Standard Precautions
				4.2.1 Components of Standard precautions
				4.2.2 Implementation of Standard precautions
				4.2.3 Hand washing
			4.3 Use of protective barriers such as gloves, gowns, aprons and masks
				4.3.1 Careful handling and disposal of sharp instruments
				4.3.2 Safe disposal of waste contaminated with body fluids
				4.3.3 Proper disinfection of instruments and other contaminated equipment
				4.3.4 Proper handling of soiled linen
				4.3.5 Sterilization and disinfection
				4.3.6 Cleaning floors
		CHAPTER 5: LABORATORY TESTS IN HIV/AIDS
			5.1 Tests for HIV Diagnosis
				5.1.1 HIV Diagnosis in Adults and Children over 18 months
				5.1.2 Diagnosing HIV infection in children under 18 months
				5.1.3 HIV Diagnostic Protocol for Abandoned Infants
			5.2 Tests for treatment eligibility and efficacy monitoring
			5.3 Tests for treatment safety monitoring
				5.3.1 Grading of adverse reactions in adults and adolescents
			5.4 Laboratory Safety Procedures
			5.5 Phlebotomy Safety Procedures
			5.6 Sample Storage Procedures
			5.7 Sample Transportation Procedure
		CHAPTER 6: HIV/AIDS AND PREGNANCY
			6.1 Introduction
			6.2 Mother to Child Transmission of HIV (MTCT)
			6.3 Prevention of Mother to Child Transmission of HIV (PMTCT)
			6.4 Antenatal care of women with HIV/AIDS
				6.4.1 Care during labour and delivery
				6.4.2 Postnatal care of a woman with HIV/AIDS
				6.4.3 Follow up for the HIV Exposed Child
				6.4.4 Use of prophylactic antiretroviral (ARV) drugs during pregnancy
		CHAPTER 7: PEDIATRIC HIV/AIDS AND RELATED CONDITIONS
			7.1 Introduction
			7.2 HIV/AIDS Manifestations in Children
			7.3 Diagnosis of HIV infection in infants
			7.4 Management of infants born to HIV positive women
			7.5Care of HIV infected Children
			7.6 Clinical manifestations of paediatric HIV infection
				7.6.1 Respiratory conditions in children with HIV infection
				7.6.2 Oro-pharyngeal candidiasis in children with HIV infection
				7.6.3 Neurologic problems in children with HIV infection
				7.6.4 Persistent generalised lymphadenopathy (PGL) in children
				7.6.5 Chronic parotitis
				7.6.6 Chronic Ear Infection
				7.6.7 Persistent or recurrent fever in children
				7.6.8 Persistent Diarrhoea
				7.6.9 Impaired growth in children with HIV infection
				7.6.10 Supportive therapy
				7.6.11 Pain control in terminally ill children
		CHAPTER 8: COMMUNITY AND HOME BASED CARE FOR PEOPLE LIVING WITH HIV/AIDS (PLHA)
			8.1 Introduction
			8.2 Concept of continuum of care and home based care
				8.2.1 Definitions
			8.3 Benefits of home based care
			8.4 Components of home based care
			8.5 Palliative Care
				8.5.1 Symptom management
				8.5.2. Terminal care
			8.6 Care of body
		CHAPTER 9: COUNSELLING RELATED TO HIV-TESTING AND TREATMENT ADHERENCE
			9.1 Introduction
			9.2 Providing HIV related counselling
			9.3 The counsellor’s role
			9.4 Pre-test counselling
			9.5 Post-test counselling
			9.6 Adherence Counselling
				9.6.1 Adherence Management and Lifestyle Counselling
				9.6.2 Counselling for treatment adherence
			9.7 Adherence Monitoring - Role of the Care and Treatment Team
		CHAPTER 10: MANAGEMENT OF COMMON SYMPTOMS AND OPPORTUNISTIC INFECTIONS IN HIV/AIDS
			10.1 Introduction
			10.2 Clinical features commonly encountered in patients with HIV/AIDS
				10.2.1 Fever
				10.2.2 Cough and dyspnoea
				10.2.3 Oropharyngeal and oesophageal Candidiasis
				10.2.4 Vaginal candidiasis
				10.2.5 Weight loss
				10.2.6 Diarrhoea
				10.2.7 Persistent generalized Lymphadenopathy
				10.2.8 Skin rashes, sores and generalized pruritis.
				10.2.9 Altered mental status and persistent severe headache
			10.3 Prophylactic treatment of common opportunistic infections in HIV/AIDS
				10.3.1 Prophylactic treatment using Co-trimoxazole
				10.3.2 Preventive therapy against TB in PLHAs
			10.4 Treatment of Opportunistic Infections:
				10.4.1 Viral infections
				10.4.2 Bacterial infections
				10.4.3 Fungal infections
				10.4.4 Protozoa
		CHAPTER 11: MANAGEMENT OF MENTAL HEALTH PROBLEMS IN HIV/AIDS
			11.1 Neurological complications with secondary mental manifestations
			11.2 Changes in mental status - Delirium (acute organic brain syndrome)
			11.3 Changes in mental status - AIDS related dementia (ADC) (chronic organic brain syndrome)
			11.4 Changes in mental status - AIDS Related Mania
			11.5 Mental complications
				11.5.1 Adjustment disorder
				11.5.2 Major Depressive Disorder
				11.5.3 Alcohol and substance use disorders
				11.5.4 Bereavement and bereavement counseling
			11.6 Crisis and crisis counseling
			11.7 Persons with previous mental disorders
		CHAPTER 12: MANAGEMENT OF HIV INFECTED PATIENTS USING ANTIRETROVIRAL DRUGS
			12.1 Introduction
			12.2 Types of Antiretroviral drugs
				12.2.1 Nucleoside Reverse Transcriptase Inhibitors (NRTIs))
				12.2.2 Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs))
				12.2.3 Protease Inhibitors (PIs)
			12.3 Treatment using ARV drugs in adults and adolescents
				12.3.1 Criteria of initiation of ART in Adults and Adolescents Patients
				12.3.2 Before initiating therapy
				12.3.3 Goals of Therapy
			12.4 Recommended ARV drugs in Tanzania
				12.4.1 Introduction
				12.4.2 First line ARV combination regimen for adults and adolescent ART naive patients
				12.4.3 Women of Childbearing Potential or Pregnant Women
				12.4.4 Antiretroviral drugs for non-ART naïve patients
			12.5 Adherence to Antiretroviral Therapy
				12.5.1 Factors that influence adherence
				12.5.2 Strategies that enhance adherence
			12.6 Changing of Antiretroviral Therapy
				12.6.1 Changing Antiretroviral therapy because of treatment failure
				12.6.2 Changing Antiretroviral therapy because of toxicity
			12.7 Second-Line ARV Regimen
			12.8 Monitoring Patients on ARV Therapy.
				12.8.1 Clinical and laboratory monitoring of patients on first line drug regimen
			12.9 Laboratory Monitoring of patients on second line drugs
				12.9.1 Scheduled visits
				12.9.2 Unscheduled visits
			12.10 Treatment failure with second line regimen
				12.10.1 In case of loss to follow up
			12.11 Contraindications (relative) for initiation of ART
			12.12 Discontinuation of ART
		CHAPTER 13: ARV THERAPY IN INFANTS AND CHILDREN
			13.1 Antiretroviral regimens for HIV infected children
			13.2 Goals of Antiretroviral Therapy in children
			13.3 Selection of Patients for Antiretroviral Therapy
			13.4 Recommended First-Line ARV Regimens in Infants and Children
			13.5 Clinical Assessment of Infants and Children Receiving ARV Therapy
			13.6 Reasons for Changing ARV Therapy in Infants and Children
				13.6.1 Clinical Conditions
				13.6.2 Immunological Conditions
				13.6.3 Virological Conditions
			13.7 Recommended Second-Line ARV Therapy for Infants and Children
		CHAPTER 14: USE OF ARVS IN SPECIAL CIRCUMSTANCES
			14.1 People with tuberculosis disease and HIV co-infection
				14.1.1 Patient presents with TB before commencing ART
			14.2 Post Exposure Prophylaxis-(PEP)
				14.2.1 Occupational exposure
				14.2.2 Treatment of an Exposure Site
				14.2.3 Exposure Report
				14.2.4 Evaluation of the Exposed HCW
				14.2.5 Drugs for PEP for HIV
				14.2.6 Timing of Post Exposure prophylaxis(PEP)
				14.2.7 Duration of Post Exposure Prophylaxis(PEP)
				14.2.8 Follow-up of Health care worker Exposed to HIV
				14.2.9 Monitoring and Management of PEP Toxicity
			14.3 HIV PEP in men and women who have been raped/sexually assaulted
				14.3.1 Counselling
				14.3.2 When to start
				14.3.3 Drug Regimen
				14.3.4 Patient monitoring
		CHAPTER 15: HIV/AIDS AND NUTRITION
			15.1 Malnutrition and HIV/AIDS
			15.2 Nutrient Requirements for People Living with HIV/AIDS (PLHA)
			15.3 Good Dietary Practices
			15.4 Dietary Practices and Nutrition for Adult PLHA and AIDS Related Symptoms
			15.5 Nutritional Issues Associated with ARVs and Other Modern Medicines
			15.6 Guidance on Effective Nutrition/Medication Management for Antiretroviral Therapy (ART)
			15.7 AIDS-wasting Syndrome
		CHAPTER 16: MANAGEMENT OF ANTIRETROVIRAL MEDICINES
			16.1 Prescriptions
			16.2 Dispensing
			16.3 Records
			16.4 Storage
			16.5 Procurement
		CHAPTER 17: CERTIFICATION OF HEALTHCARE FACILITIES AS CARE AND TREATMENT SITES
			17.1 Overview

National Guidelines for the Clinical Management of HIV/AIDS - Tanzania

THE UNITED REPUBLIC OF TANZANIA

MINISTRY OF HEALTH

National AIDS Control Programme (NACP)
Second edition, April 2005

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