Page 29 - Children Bookt.pdf
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7. Starting ART
Conditions necessary to introduce antiretroviral therapy
Access to functioning and affordable health services and support networks
into which ARV treatment can be integrated so that the treatments are provided
effectively
Information and training on safe and effective use of ARVs for health
professionals in a position to prescribe ARVs
Capacity to diagnose HIV infection and to diagnose and treat concomitant
illnesses.
Assurance of adequate supply of quality drugs
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basis; patients must be aware that treatment is ‘for life’
Functioning laboratory services for monitoring including routine
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Access to voluntary HIV counselling and testing (VCT) and follow up
counselling services should be assured, including counselling on the necessity
of adherence to treatment.
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Table (7) Recommendations for initiating ART in infants and children; revised
in 2010
Infants and children ^
Five years of age
Age
<24 months of age a,b 59months of age or older
%CD4+ All c { NA
3
Absolute x{
"
All c {
" x
CD4 (As in adults)
(a) All HIV-infected infants should receive ART due to the rapid rate of disease
progression.
(b) Countries with reliable access to CD4 monitoring may choose to apply clinical and
immunological criteria for initiation of ART in children aged 12 – 23 months
(c) In children with absolute lymphopaenia, the CD4 percentage (%CD4+) may be
falsely elevated.
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