Malawi Clinical Management of HIV In Children and Adults 2014

In July 2013, the WHO released new Consolidated Guidelines for the Use of Antiretroviral Drugs for Treating and Prevention of HIV Infection. The 2013 WHO guidelines advocate for the use of ARVs within a broad continuum of care and include guidance for implementation and M&E. This strategy of harmonization, integration and simplification follows the same principles that were introduced in the 1st Edition of the Malawi Guidelines in 2011.

2013 WHO recommendations include:

• Further expansion of ART eligibility: CD4 count threshold ≤500 cells/mm3; universal eligibility for HIV infected pregnant and breastfeeding women, for children under 5 years, for patients co-infected with TB or severe chronic hepatitis B, etc. However, priority should be given to people with severe HIV disease and/or CD4≤350.
• Expanded use of ARVs for prevention of HIV infection (universal ART for pregnant / breastfeeding women and for discordant couples; pre- and post-exposure prophylaxis in certain situations)
• Use of simple, safer, once-daily, single-pill ARV regimens suitable for most patient groups.
• Use of viral load for monitoring ART success and diagnosing treatment failure.
• Expansion of HIV testing with linkage to prevention, care and treatment services.