This document provides guidelines on when to start antiretroviral therapy (ART) in adults and adolescents living with HIV. It recommends that all HIV-infected individuals start ART as soon as possible for their health and to prevent transmission. A clinical assessment should be performed to determine conditions that will help select an appropriate ART regimen. ART eligibility is based on WHO clinical staging, CD4 count, viral load, and public health considerations. First-line regimens generally consist of two nucleoside reverse transcriptase inhibitors plus a non-nucleoside reverse transcriptase inhibitor or integrase strand transfer inhibitor. Important factors for countries adapting WHO guidelines include accessibility, quality of care, equity, efficiency and sustainability. Immune reconstitution
National HIV testing and treatment guidelines BISHAL SAPKOTA
1. The document provides guidelines for HIV testing, treatment, and management in Nepal. It summarizes global HIV statistics and outlines the epidemiology of HIV in Nepal.
2. Guidelines are provided for HIV testing services, diagnosis, treatment, monitoring of people on antiretroviral therapy (ART), and management of coinfections. Recommendations include "treat all" and early infant diagnosis.
3. Prevention of mother-to-child transmission (PMTCT), ART for prevention, post-exposure prophylaxis, and combination prevention are discussed. Clinical features and management of pediatric HIV are also reviewed.
This document provides information on HIV/AIDS including its epidemiology, transmission, stages, diagnosis, treatment and prevention. It describes HIV/AIDS as a global public health issue and outlines prevention strategies like safe sex practices, antiretroviral treatment, prevention of mother-to-child transmission and harm reduction for intravenous drug users. Statistics on HIV prevalence in Pakistan are presented alongside the national AIDS control program and its strategies to promote awareness, testing and care.
HIV originated from chimpanzees in West Africa and was transmitted to humans. The earliest known case of HIV in a human was detected in 1959 in the Democratic Republic of Congo. Antiretroviral therapy uses HIV medicines to treat infection and suppress viral load, preventing transmission. Factors like viral load, condom use, and adherence to medication determine likelihood of HIV transmission. Common signs of HIV infection include fever, fatigue, swollen lymph nodes, and skin rashes.
A 47-year-old woman presented with fever, cough, and difficulty breathing for one week. She was diagnosed with HIV 5 years ago but stopped treatment after one month. She now has oral thrush, tachycardia, and crackles in her lungs. Her CD4 count is low at 235 and HIV viral load is high. She is diagnosed with Pneumocystis jiroveci pneumonia, an opportunistic infection seen in advanced HIV/AIDS due to her severely compromised immune system from lack of antiretroviral treatment.
The document discusses recent advances in case management of HIV/AIDS. It covers various aspects of the continuum of care including HIV testing and counseling, linkage to care, enrollment and retention in care programs, preparation for antiretroviral therapy (ART), management of co-infections and comorbidities, initiation of first and second line ART, monitoring of treatment response and toxicity. It also summarizes World Health Organization guidelines on when to start ART, first and second line regimens, and highlights the shift to a universal "treat all" strategy.
The 2013 consolidated WHO guidelines provide recommendations for treating and preventing HIV across the continuum of care. Key features include:
- Simplified once-daily ART regimens including TDF+FTC/3TC+EFV as the preferred first-line regimen for adults and adolescents.
- "Option B+" is recommended - lifelong ART for all pregnant and breastfeeding women for prevention of mother-to-child transmission.
- Earlier treatment is recommended - ART is to be initiated in all individuals with CD4 ≤500 cells/mm3 or clinical stage 3/4 disease regardless of CD4 count.
The document discusses hepatitis C, including its virology, transmission, symptoms, screening, treatment and prevention. It provides epidemiological data on chronic hepatitis C in Georgia from 2009-2014. Specifically, it finds that 50% of reported viral hepatitis cases in Georgia during this period were chronic hepatitis C. It also analyzes the age distribution and geographic distribution of chronic hepatitis C cases.
The document provides guidelines on the clinical staging, treatment, and management of HIV/AIDS. It discusses:
1) The 4 categories of clinical presentations of HIV infection and the revised WHO clinical staging criteria.
2) The significance of CD4 counts in determining immunosuppression and criteria for initiating antiretroviral therapy (ART) based on clinical stage and CD4 level.
3) Preferred first and second line ART regimens for different groups, and considerations for third line ART and post exposure prophylaxis.
National HIV testing and treatment guidelines BISHAL SAPKOTA
1. The document provides guidelines for HIV testing, treatment, and management in Nepal. It summarizes global HIV statistics and outlines the epidemiology of HIV in Nepal.
2. Guidelines are provided for HIV testing services, diagnosis, treatment, monitoring of people on antiretroviral therapy (ART), and management of coinfections. Recommendations include "treat all" and early infant diagnosis.
3. Prevention of mother-to-child transmission (PMTCT), ART for prevention, post-exposure prophylaxis, and combination prevention are discussed. Clinical features and management of pediatric HIV are also reviewed.
This document provides information on HIV/AIDS including its epidemiology, transmission, stages, diagnosis, treatment and prevention. It describes HIV/AIDS as a global public health issue and outlines prevention strategies like safe sex practices, antiretroviral treatment, prevention of mother-to-child transmission and harm reduction for intravenous drug users. Statistics on HIV prevalence in Pakistan are presented alongside the national AIDS control program and its strategies to promote awareness, testing and care.
HIV originated from chimpanzees in West Africa and was transmitted to humans. The earliest known case of HIV in a human was detected in 1959 in the Democratic Republic of Congo. Antiretroviral therapy uses HIV medicines to treat infection and suppress viral load, preventing transmission. Factors like viral load, condom use, and adherence to medication determine likelihood of HIV transmission. Common signs of HIV infection include fever, fatigue, swollen lymph nodes, and skin rashes.
A 47-year-old woman presented with fever, cough, and difficulty breathing for one week. She was diagnosed with HIV 5 years ago but stopped treatment after one month. She now has oral thrush, tachycardia, and crackles in her lungs. Her CD4 count is low at 235 and HIV viral load is high. She is diagnosed with Pneumocystis jiroveci pneumonia, an opportunistic infection seen in advanced HIV/AIDS due to her severely compromised immune system from lack of antiretroviral treatment.
The document discusses recent advances in case management of HIV/AIDS. It covers various aspects of the continuum of care including HIV testing and counseling, linkage to care, enrollment and retention in care programs, preparation for antiretroviral therapy (ART), management of co-infections and comorbidities, initiation of first and second line ART, monitoring of treatment response and toxicity. It also summarizes World Health Organization guidelines on when to start ART, first and second line regimens, and highlights the shift to a universal "treat all" strategy.
The 2013 consolidated WHO guidelines provide recommendations for treating and preventing HIV across the continuum of care. Key features include:
- Simplified once-daily ART regimens including TDF+FTC/3TC+EFV as the preferred first-line regimen for adults and adolescents.
- "Option B+" is recommended - lifelong ART for all pregnant and breastfeeding women for prevention of mother-to-child transmission.
- Earlier treatment is recommended - ART is to be initiated in all individuals with CD4 ≤500 cells/mm3 or clinical stage 3/4 disease regardless of CD4 count.
The document discusses hepatitis C, including its virology, transmission, symptoms, screening, treatment and prevention. It provides epidemiological data on chronic hepatitis C in Georgia from 2009-2014. Specifically, it finds that 50% of reported viral hepatitis cases in Georgia during this period were chronic hepatitis C. It also analyzes the age distribution and geographic distribution of chronic hepatitis C cases.
The document provides guidelines on the clinical staging, treatment, and management of HIV/AIDS. It discusses:
1) The 4 categories of clinical presentations of HIV infection and the revised WHO clinical staging criteria.
2) The significance of CD4 counts in determining immunosuppression and criteria for initiating antiretroviral therapy (ART) based on clinical stage and CD4 level.
3) Preferred first and second line ART regimens for different groups, and considerations for third line ART and post exposure prophylaxis.
The document discusses anti-retroviral therapy for HIV/AIDS. It provides information on diagnosing HIV, clinical assessment of patients, treatment regimens and monitoring. It discusses treatment for special groups like pregnant women, infants, children and those with HIV-TB co-infection. The goals of anti-retroviral therapy are to improve survival, quality of life, reduce viral load and increase CD4 count while limiting toxicity. The National AIDS Control Program aims to achieve zero new infections, deaths and discrimination related to HIV/AIDS in India by 2030.
This document provides information on the medical and nursing management of patients with HIV infection. It discusses the objectives of management which include early identification of HIV, continuous care of asymptomatic patients, early intervention, adequate medical care and therapy, and delaying progression to AIDS. The medical management is described in stages from asymptomatic to AIDS-related illnesses. Key aspects of management include risk assessment, establishing diagnosis, determining stage, laboratory tests, initiating antiretroviral therapy and PCP prophylaxis. Nursing management focuses on health education, universal precautions, and prevention. Alternative therapies discussed for treatment include physical therapies like yoga and massage, relaxation techniques, and herbal medicines.
Theodoros F. Katsivas, M.D., M.A.S., of UC San Diego Owen Clinic, presents "San Diego Primary Care Providers' Attitudes to HIV and HIV Testing" at AIDS Clinical Rounds
This document provides information about HIV/AIDS, including its causes, symptoms, testing, treatment and prevention. It defines HIV as the virus that causes AIDS, with HIV being the infectious stage and AIDS being the late stage disease. Some key points include:
- HIV attacks CD4 cells and progresses from acute infection to asymptomatic infection to AIDS without treatment
- Common symptoms of AIDS include opportunistic infections like PCP, tuberculosis, and cancers like Kaposi's sarcoma
- Screening and confirmatory tests are used to diagnose HIV, and treatment involves antiretroviral drugs as lifelong therapy
- Prevention methods include safe sex practices, needle exchange, blood safety, and antiretroviral treatment of infected
Egypt has the largest hepatitis C virus (HCV) epidemic in the world, with around 12% of the population infected. Unsafe injection practices from medical procedures are a major source of HCV transmission in Egypt. A suggested national HCV prevention strategy includes: 1) primary prevention through safe injection practices and infection control; 2) secondary prevention by identifying infected individuals and reducing transmission risk; 3) educating healthcare workers and the public; and 4) conducting surveillance and evaluating prevention activities. The strategy aims to prevent new HCV infections and reduce the risk of chronic liver disease in infected individuals through medical management and lifestyle changes.
This document provides an overview of HIV/AIDS including epidemiology, transmission, clinical management, counseling, testing, and prevention. It discusses how HIV/AIDS has impacted populations internationally, nationally, and in Florida. Modes of HIV transmission include sexual contact, perinatal transmission from mother to child, exposure to infected blood, and occupational exposure for healthcare workers. Clinical management involves use of antiretroviral therapy to suppress viral load and prevent opportunistic infections. Counseling, testing, and prevention strategies can help curb further spread of the disease.
A Presentation Presented To orient about HIV, AIDS and STIs for Development of Knowledge, Attitude, and Practice for Prevention of HIV and STIs for College Students.
7. When to start ART (Eligibility)Rev.pptxyakemichael
This document provides guidance on when to start antiretroviral therapy (ART) for people living with HIV. It discusses that ART should be initiated as soon as possible for eligible patients to achieve viral suppression and prevent clinical complications, but is not generally an emergency. It outlines the medical eligibility criteria for starting ART based on CD4 count and clinical stage for both adults and children. It also discusses important considerations for selecting an appropriate first-line regimen, including potential medical contraindications to specific antiretrovirals, as well as assessing non-medical barriers to adherence. The key steps are to evaluate if a patient meets medical criteria for treatment, has any medical reasons they cannot start first-line drugs, consider special situations like
This document discusses Acquired Immunodeficiency Syndrome (AIDS). It defines AIDS as a condition caused by the human immunodeficiency virus (HIV) that weakens the immune system. HIV is transmitted through sexual contact, exposure to infected body fluids, or from mother to child. A person may not notice symptoms initially or may experience brief flu-like symptoms before entering a prolonged asymptomatic phase. Late stage symptoms occur as the virus interferes more with the immune system, increasing risk of infections. Diagnosis involves HIV testing to detect antibodies or genetic material from the virus. There is currently no cure for AIDS but treatment involves antiretroviral therapy to slow disease progression.
1
Final Course Project Outline
Final Course Project Outline: The Role of Pharmaceutical Industry in
the Era of Climate Change
Ruinan Yang
King Graduate School, Monroe College
MG630: Organizational Behavior and Leadership in the 21st Century
Dr. Judith Riggs
November 20, 2021
2
Final Course Project Outline
I. Introduction
a. Environmental, Social and Governance (ESG)
b. Climate change and sustainable development
II. Case Study on Pharmaceutical Companies with Notable ESG
Scores
a. What is ESG score?
b. Case study: Boehringer Ingelheim, a German pharmaceutical company
III. Critical Analysis of The Role of Pharmaceutical Industry on Climate Change
IV. Conclusion: My Role as a Leader
V. Reference
HIV AND AIDS
TITLE
Prepared by:
Teacher :
OUTLINE:
Introduction
Pathogenesis
Risk factors
Clinical Manifestation
Diagnosis
History taking
Physical examination
Laboratory studies
VI. Infection control Policies
VII. Nursing Diagnosis And Intervention
VIII. Summary
OBJECTIVES:
At the end of this lecture, students will be able to:
1. Know and understand what is HIV AND AIDS.
2. Understand the process how disease develop.
3. Practice how to deal and take care a patient according to infection control sets of guidelines.
4. Identify Nursing diagnosis and make interventions that help promote patient care and comfort.
INTRODUCTION
The human immunodeficiency virus (HIV) targets the immune system and weakens people's defense against many infections and some types of cancer that people with healthy immune systems can fight off. As the virus destroys and impairs the function of immune cells, infected individuals gradually become immunodeficient. Immune function is typically measured by CD4 cell count.
The most advanced stage of HIV infection is acquired immunodeficiency syndrome (AIDS), which can take many years to develop if not treated, depending on the individual. AIDS is defined by the development of certain cancers, infections or other severe long-term clinical manifestations.
Since HIV was first identified almost 30 years ago, remarkable progress has been made in improving the quality and duration of life for people living with HIV disease.
HIV or human immunodeficiency virus and acquired immunodeficiency syndrome is a chronic condition that requires daily medication.
HIV- 1 is a retrovirus isolated and recognized as the etiologic agent of AIDS.
HIV-2 is a retrovirus identified in 1986 in AIDS patients in West
HIV
AIDS
is defined by the Centers for Disease Control and Prevention (CDC) as any person with HIV infection and a CD4 lymphocyte count below 200 cells/mcL (or a CD4 count below 14%) or having an AIDS-indicator condition
The primary route of transmission of the HIV virus is by entering the mucosal surface (predominantly sexual contact).
Following mucosal entry, the virus binds to peripheral circulating T cells and macrophages (e.g., dendritic cells) that express the CD4 and CCR5 receptors.
As the dis ...
The document provides information on Hepatitis C virus (HCV) including its definition, background prevalence data, transmission routes, screening and testing approaches, natural history, symptoms, treatment options, and standard precautions. It notes that HCV is a blood-borne virus that infects the liver and is transmitted through exposure to infected blood. An estimated 3% of the global population has been infected with HCV.
The document discusses HIV disease staging according to the World Health Organization (WHO). It describes the three phases of HIV infection: acute phase, chronic phase, and final phase. It outlines the four WHO clinical stages of HIV/AIDS based on presence of conditions: asymptomatic, mild symptoms, advanced illness, and severe illness/AIDS. The stages are used to monitor disease progression and guide clinical management. Accurate staging requires assessing CD4 count and presence of defining illnesses.
The document provides an overview of HIV/AIDS including:
1. The history and epidemiology of HIV/AIDS globally and in Egypt. HIV was first identified in 1981 and transmission occurs through unprotected sex, blood transfusions, and mother-to-child. Rates in Egypt have increased in recent years.
2. The life cycle and stages of HIV infection from initial binding to T-cells through replication and progression to AIDS if untreated.
3. Effective prevention methods including antiretroviral treatment for pregnant women, voluntary medical male circumcision, pre-exposure prophylaxis, and consistent condom use which can reduce risk of transmission by over 90%.
The document discusses viral load (VL) monitoring for patients on antiretroviral therapy (ART). VL is the preferred method to monitor treatment response as it identifies treatment failure earlier than CD4 or clinical criteria. A suppressed VL (<1000 copies/ml) after 6 months of ART indicates an acceptable response and reduces the risk of disease progression and onward HIV transmission. Strategies are needed in South Sudan to improve low viral load coverage, including a VL catch-up surge to increase coverage from 67% to 85% by March 2021 through addressing various barriers like availability of testing, provider knowledge, identification of eligible clients, access issues, and demand creation.
1) COVID-19 infection in children is generally mild and self-limiting compared to adults, with most children recovering within 1-2 weeks. Symptoms are similar to adults but milder.
2) While infection rates are lower in children, infants may be at higher risk for severe illness. Asymptomatic transmission is still possible.
3) Diagnosis is made through RT-PCR testing of respiratory samples. Chest CT may show ground-glass opacities or consolidations.
4) Treatment is supportive and includes oxygen therapy. Antivirals like lopinavir/ritonavir are being studied but no proven therapy currently exists.
TB Case Finding among PLHIV-Nov_2_2022.pptxyakemichael
This document provides guidelines on tuberculosis (TB) screening among people living with HIV (PLHIV) based on recent WHO recommendations. It discusses various screening tools and algorithms for different subpopulations of PLHIV, including symptoms screening, chest x-ray, CRP, and molecular rapid diagnostic tests. It recommends a sequential positive screening algorithm using the four-symptom screen followed by CRP for outpatients not on ART, and combining symptoms screening with chest x-ray for outpatients on ART. For children under 10 and medical inpatients, it recommends single screening tools. The document also provides a specific algorithm for TB diagnosis among PLHIV using lateral flow lipoarabinomannan testing.
Adults and Adolescents ART Guidelines AI.pptxshillahhungwe
Adult ART according to the the new 2022 guidelines.Viral load monitoring now is categorized as target not detectable,low viraemia and high viraemia.EAC sessions now given to both low and high viraemia recipients of care and monthly repeat viral load is collected for monitoring.
Switching to second line is only done when there is high viraemia on the second repeat viral load after EAC sessions.
The document discusses HIV/AIDS, its transmission, prevention and treatment. It begins by defining HIV as the virus that causes AIDS by attacking the immune system. AIDS is the late stage of HIV infection defined by a CD4 count below 200 or opportunistic infections. HIV is transmitted via blood, semen, vaginal fluids etc. Prevention methods discussed include condoms, voluntary medical male circumcision, antiretroviral drugs as pre-exposure prophylaxis, and eliminating mother-to-child transmission. Treatment involves lifelong antiretroviral therapy to suppress the virus and allow immune recovery.
This document provides an overview of qualitative research designs. It defines qualitative research and lists factors to consider when using a qualitative approach, such as the research problem, personal experiences of the researcher, and intended audience. Qualitative research is described as focusing on words, perceptions and concepts. The document then discusses when a qualitative approach would be applied, such as when exploring human behaviors, attitudes and experiences. Several qualitative research methods are outlined in brief, including phenomenology, ethnography and grounded theory.
Hypothyroidism is a deficiency of thyroid hormone that causes slowed body functions. It can be caused by iodine deficiency, thyroid surgery removing part or all of the gland, or congenital defects. Signs include fatigue, cold intolerance, weight gain, constipation, and anemia. Hypothyroidism is managed through levothyroxine medication to replace thyroid hormone, a high fiber diet, and physical exercise.
The document discusses anti-retroviral therapy for HIV/AIDS. It provides information on diagnosing HIV, clinical assessment of patients, treatment regimens and monitoring. It discusses treatment for special groups like pregnant women, infants, children and those with HIV-TB co-infection. The goals of anti-retroviral therapy are to improve survival, quality of life, reduce viral load and increase CD4 count while limiting toxicity. The National AIDS Control Program aims to achieve zero new infections, deaths and discrimination related to HIV/AIDS in India by 2030.
This document provides information on the medical and nursing management of patients with HIV infection. It discusses the objectives of management which include early identification of HIV, continuous care of asymptomatic patients, early intervention, adequate medical care and therapy, and delaying progression to AIDS. The medical management is described in stages from asymptomatic to AIDS-related illnesses. Key aspects of management include risk assessment, establishing diagnosis, determining stage, laboratory tests, initiating antiretroviral therapy and PCP prophylaxis. Nursing management focuses on health education, universal precautions, and prevention. Alternative therapies discussed for treatment include physical therapies like yoga and massage, relaxation techniques, and herbal medicines.
Theodoros F. Katsivas, M.D., M.A.S., of UC San Diego Owen Clinic, presents "San Diego Primary Care Providers' Attitudes to HIV and HIV Testing" at AIDS Clinical Rounds
This document provides information about HIV/AIDS, including its causes, symptoms, testing, treatment and prevention. It defines HIV as the virus that causes AIDS, with HIV being the infectious stage and AIDS being the late stage disease. Some key points include:
- HIV attacks CD4 cells and progresses from acute infection to asymptomatic infection to AIDS without treatment
- Common symptoms of AIDS include opportunistic infections like PCP, tuberculosis, and cancers like Kaposi's sarcoma
- Screening and confirmatory tests are used to diagnose HIV, and treatment involves antiretroviral drugs as lifelong therapy
- Prevention methods include safe sex practices, needle exchange, blood safety, and antiretroviral treatment of infected
Egypt has the largest hepatitis C virus (HCV) epidemic in the world, with around 12% of the population infected. Unsafe injection practices from medical procedures are a major source of HCV transmission in Egypt. A suggested national HCV prevention strategy includes: 1) primary prevention through safe injection practices and infection control; 2) secondary prevention by identifying infected individuals and reducing transmission risk; 3) educating healthcare workers and the public; and 4) conducting surveillance and evaluating prevention activities. The strategy aims to prevent new HCV infections and reduce the risk of chronic liver disease in infected individuals through medical management and lifestyle changes.
This document provides an overview of HIV/AIDS including epidemiology, transmission, clinical management, counseling, testing, and prevention. It discusses how HIV/AIDS has impacted populations internationally, nationally, and in Florida. Modes of HIV transmission include sexual contact, perinatal transmission from mother to child, exposure to infected blood, and occupational exposure for healthcare workers. Clinical management involves use of antiretroviral therapy to suppress viral load and prevent opportunistic infections. Counseling, testing, and prevention strategies can help curb further spread of the disease.
A Presentation Presented To orient about HIV, AIDS and STIs for Development of Knowledge, Attitude, and Practice for Prevention of HIV and STIs for College Students.
7. When to start ART (Eligibility)Rev.pptxyakemichael
This document provides guidance on when to start antiretroviral therapy (ART) for people living with HIV. It discusses that ART should be initiated as soon as possible for eligible patients to achieve viral suppression and prevent clinical complications, but is not generally an emergency. It outlines the medical eligibility criteria for starting ART based on CD4 count and clinical stage for both adults and children. It also discusses important considerations for selecting an appropriate first-line regimen, including potential medical contraindications to specific antiretrovirals, as well as assessing non-medical barriers to adherence. The key steps are to evaluate if a patient meets medical criteria for treatment, has any medical reasons they cannot start first-line drugs, consider special situations like
This document discusses Acquired Immunodeficiency Syndrome (AIDS). It defines AIDS as a condition caused by the human immunodeficiency virus (HIV) that weakens the immune system. HIV is transmitted through sexual contact, exposure to infected body fluids, or from mother to child. A person may not notice symptoms initially or may experience brief flu-like symptoms before entering a prolonged asymptomatic phase. Late stage symptoms occur as the virus interferes more with the immune system, increasing risk of infections. Diagnosis involves HIV testing to detect antibodies or genetic material from the virus. There is currently no cure for AIDS but treatment involves antiretroviral therapy to slow disease progression.
1
Final Course Project Outline
Final Course Project Outline: The Role of Pharmaceutical Industry in
the Era of Climate Change
Ruinan Yang
King Graduate School, Monroe College
MG630: Organizational Behavior and Leadership in the 21st Century
Dr. Judith Riggs
November 20, 2021
2
Final Course Project Outline
I. Introduction
a. Environmental, Social and Governance (ESG)
b. Climate change and sustainable development
II. Case Study on Pharmaceutical Companies with Notable ESG
Scores
a. What is ESG score?
b. Case study: Boehringer Ingelheim, a German pharmaceutical company
III. Critical Analysis of The Role of Pharmaceutical Industry on Climate Change
IV. Conclusion: My Role as a Leader
V. Reference
HIV AND AIDS
TITLE
Prepared by:
Teacher :
OUTLINE:
Introduction
Pathogenesis
Risk factors
Clinical Manifestation
Diagnosis
History taking
Physical examination
Laboratory studies
VI. Infection control Policies
VII. Nursing Diagnosis And Intervention
VIII. Summary
OBJECTIVES:
At the end of this lecture, students will be able to:
1. Know and understand what is HIV AND AIDS.
2. Understand the process how disease develop.
3. Practice how to deal and take care a patient according to infection control sets of guidelines.
4. Identify Nursing diagnosis and make interventions that help promote patient care and comfort.
INTRODUCTION
The human immunodeficiency virus (HIV) targets the immune system and weakens people's defense against many infections and some types of cancer that people with healthy immune systems can fight off. As the virus destroys and impairs the function of immune cells, infected individuals gradually become immunodeficient. Immune function is typically measured by CD4 cell count.
The most advanced stage of HIV infection is acquired immunodeficiency syndrome (AIDS), which can take many years to develop if not treated, depending on the individual. AIDS is defined by the development of certain cancers, infections or other severe long-term clinical manifestations.
Since HIV was first identified almost 30 years ago, remarkable progress has been made in improving the quality and duration of life for people living with HIV disease.
HIV or human immunodeficiency virus and acquired immunodeficiency syndrome is a chronic condition that requires daily medication.
HIV- 1 is a retrovirus isolated and recognized as the etiologic agent of AIDS.
HIV-2 is a retrovirus identified in 1986 in AIDS patients in West
HIV
AIDS
is defined by the Centers for Disease Control and Prevention (CDC) as any person with HIV infection and a CD4 lymphocyte count below 200 cells/mcL (or a CD4 count below 14%) or having an AIDS-indicator condition
The primary route of transmission of the HIV virus is by entering the mucosal surface (predominantly sexual contact).
Following mucosal entry, the virus binds to peripheral circulating T cells and macrophages (e.g., dendritic cells) that express the CD4 and CCR5 receptors.
As the dis ...
The document provides information on Hepatitis C virus (HCV) including its definition, background prevalence data, transmission routes, screening and testing approaches, natural history, symptoms, treatment options, and standard precautions. It notes that HCV is a blood-borne virus that infects the liver and is transmitted through exposure to infected blood. An estimated 3% of the global population has been infected with HCV.
The document discusses HIV disease staging according to the World Health Organization (WHO). It describes the three phases of HIV infection: acute phase, chronic phase, and final phase. It outlines the four WHO clinical stages of HIV/AIDS based on presence of conditions: asymptomatic, mild symptoms, advanced illness, and severe illness/AIDS. The stages are used to monitor disease progression and guide clinical management. Accurate staging requires assessing CD4 count and presence of defining illnesses.
The document provides an overview of HIV/AIDS including:
1. The history and epidemiology of HIV/AIDS globally and in Egypt. HIV was first identified in 1981 and transmission occurs through unprotected sex, blood transfusions, and mother-to-child. Rates in Egypt have increased in recent years.
2. The life cycle and stages of HIV infection from initial binding to T-cells through replication and progression to AIDS if untreated.
3. Effective prevention methods including antiretroviral treatment for pregnant women, voluntary medical male circumcision, pre-exposure prophylaxis, and consistent condom use which can reduce risk of transmission by over 90%.
The document discusses viral load (VL) monitoring for patients on antiretroviral therapy (ART). VL is the preferred method to monitor treatment response as it identifies treatment failure earlier than CD4 or clinical criteria. A suppressed VL (<1000 copies/ml) after 6 months of ART indicates an acceptable response and reduces the risk of disease progression and onward HIV transmission. Strategies are needed in South Sudan to improve low viral load coverage, including a VL catch-up surge to increase coverage from 67% to 85% by March 2021 through addressing various barriers like availability of testing, provider knowledge, identification of eligible clients, access issues, and demand creation.
1) COVID-19 infection in children is generally mild and self-limiting compared to adults, with most children recovering within 1-2 weeks. Symptoms are similar to adults but milder.
2) While infection rates are lower in children, infants may be at higher risk for severe illness. Asymptomatic transmission is still possible.
3) Diagnosis is made through RT-PCR testing of respiratory samples. Chest CT may show ground-glass opacities or consolidations.
4) Treatment is supportive and includes oxygen therapy. Antivirals like lopinavir/ritonavir are being studied but no proven therapy currently exists.
TB Case Finding among PLHIV-Nov_2_2022.pptxyakemichael
This document provides guidelines on tuberculosis (TB) screening among people living with HIV (PLHIV) based on recent WHO recommendations. It discusses various screening tools and algorithms for different subpopulations of PLHIV, including symptoms screening, chest x-ray, CRP, and molecular rapid diagnostic tests. It recommends a sequential positive screening algorithm using the four-symptom screen followed by CRP for outpatients not on ART, and combining symptoms screening with chest x-ray for outpatients on ART. For children under 10 and medical inpatients, it recommends single screening tools. The document also provides a specific algorithm for TB diagnosis among PLHIV using lateral flow lipoarabinomannan testing.
Adults and Adolescents ART Guidelines AI.pptxshillahhungwe
Adult ART according to the the new 2022 guidelines.Viral load monitoring now is categorized as target not detectable,low viraemia and high viraemia.EAC sessions now given to both low and high viraemia recipients of care and monthly repeat viral load is collected for monitoring.
Switching to second line is only done when there is high viraemia on the second repeat viral load after EAC sessions.
The document discusses HIV/AIDS, its transmission, prevention and treatment. It begins by defining HIV as the virus that causes AIDS by attacking the immune system. AIDS is the late stage of HIV infection defined by a CD4 count below 200 or opportunistic infections. HIV is transmitted via blood, semen, vaginal fluids etc. Prevention methods discussed include condoms, voluntary medical male circumcision, antiretroviral drugs as pre-exposure prophylaxis, and eliminating mother-to-child transmission. Treatment involves lifelong antiretroviral therapy to suppress the virus and allow immune recovery.
This document provides an overview of qualitative research designs. It defines qualitative research and lists factors to consider when using a qualitative approach, such as the research problem, personal experiences of the researcher, and intended audience. Qualitative research is described as focusing on words, perceptions and concepts. The document then discusses when a qualitative approach would be applied, such as when exploring human behaviors, attitudes and experiences. Several qualitative research methods are outlined in brief, including phenomenology, ethnography and grounded theory.
Hypothyroidism is a deficiency of thyroid hormone that causes slowed body functions. It can be caused by iodine deficiency, thyroid surgery removing part or all of the gland, or congenital defects. Signs include fatigue, cold intolerance, weight gain, constipation, and anemia. Hypothyroidism is managed through levothyroxine medication to replace thyroid hormone, a high fiber diet, and physical exercise.
This document discusses quantitative research design. It begins by defining quantitative research as collecting, analyzing, and interpreting numerical data, often from a large sample population. The document then outlines specific objectives and introduces descriptive and analytical study designs. It differentiates experimental from non-experimental analytical studies, providing examples of cohort, case-control, cross-sectional, and ecological study types. In conclusion, the summary restates that quantitative research deals with numbers to analyze groups and can be descriptive or analytical, including experimental and non-experimental methodologies.
This document discusses data collection and management. It defines data collection as gathering information in a systematic way to answer research questions. It describes qualitative and quantitative methods of data collection, including interviews, participant observation, and questionnaires. Guidelines are provided for developing questionnaires, including using simple language, asking one concept per question, and phrasing questions neutrally. The document also explains that data management is organizing, storing, and sharing research data. It emphasizes the importance of data management for increasing research impact, avoiding duplication, and ensuring integrity.
Quantitative designs involve systematically gathering numerical data to investigate phenomena. They can be experimental, involving interventions, or non-experimental via descriptive, analytical, cohort, case-control, cross-sectional, or ecological studies. Quantitative designs are used to test theories, develop models, and identify relationships between variables through statistical analysis. They provide reliable, generalizable data but require large sample sizes and may not explain behaviors.
The document discusses ethical issues in research. It defines key concepts like ethics, ethical issues, and research ethics. It outlines important ethical principles like non-maleficence, beneficence, autonomy, and justice. It examines major ethical issues such as informed consent, risks and benefits, confidentiality, vulnerable groups, and communicating results. It analyzes historical examples that violated ethics like the Nazi experiments and Tuskegee syphilis study. In summary, the document outlines the importance of addressing ethical considerations in research to protect participants and build trust.
This document discusses nutrition in pregnancy. It begins by outlining the learning objectives which are to explain the importance of diet for pregnant women, describe general nutritional needs and common problems, and identify dietary factors for antenatal history. The introduction states that a well-nourished mother ensures a healthy baby and nation. The document then covers nutritional requirements, importance of diet for fetal development and delivery comfort, and increased needs for vitamins, minerals, proteins, calories and micronutrients during pregnancy. Common nutritional problems and weight gain in pregnancy are also discussed.
The document discusses research dissemination presented by Group 11 members. It provides broad and specific objectives of the presentation, which are to describe the research dissemination process and related terms, types of research dissemination, components and planning of disseminating research, as well as the importance and methods. It defines key terms like research and dissemination, and describes the types, components, principles, problems and solutions of research dissemination.
This document outlines pre-operative care, which prepares patients physically and psychologically for surgery. It defines pre-operative care and describes assessing patients' medical history, identifying risks, explaining procedures, gaining consent, reducing risks through testing and treatment, educating patients, and preparing them for surgery with activities like fasting and intravenous lines. The goal is to make surgery safer by addressing all patient needs and concerns before they enter the operating area.
Professional nursing organizations exist at local, national, and international levels to promote the nursing profession and public interest. They provide benefits like professional growth opportunities through training, influencing policies, enhancing CVs, networking, and certification programs. Organizations represent all nurses, specific specialties, or special interests. Some examples mentioned are ECSACON, ICN, Sigma Theta Tau, NONM, AMAMI, and NMCM.
This document contains 6 scenarios describing different patient cases. Scenario 1 involves inserting an indwelling catheter for a patient with urinary incontinence. Scenario 2 involves teaching a student how to administer insulin using a sliding scale for a diabetic patient with high blood sugar. Scenario 3 involves assessing a patient diagnosed with depression for key symptoms of depression. Scenario 4 involves providing health education on drugs and diet for a hypertensive patient. Scenario 5 involves commencing an intravenous infusion for a patient with severe dehydration. Scenario 6 involves performing an immediate postoperative assessment for a patient who had surgery for bowel obstruction.
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1. WHEN TO START ANTI-RETROVIRAL
THERAPY IN ADULTS AND
ADOLESCENTS
BY GROUP 16
2. BROAD OBJECTIVES
• By the end of this presentation learners should be
able to know and understand the criterias for ART
initiation
3. SPECIFIC OBJECTIVES
• To explain when to start antiretroviral therapy in adults and
adolescents
• To explain the clinical assessment of HIV infected adults and
adolescents
• To describe the benefits and risks of starting ART
• To describe WHO clinical staging of HIV
4. OBJECTIVES CONTINU…
• To explain the immunological assessment of HIV infected
adults and adolescents
• To explain the virological assessment of HIV infected adults
and adolescents
• To explain the consideration for treatment on the basis of a
public health approach
5. OBJECTIVES CONTI….
• To construct first line regimens
• To describe important points before adapting the ARV regimens
by nations
• To describe the recommendations by WHO
• To describe pathophysiology and management of IRIS
6. WHEN TO START ART IN ADULTS AND
ADOLESCENTS?
• All HIV confirmed infected people should start ART as soon as
possible for their own health and to prevent passing the virus on
to others.
7. CLINICAL ASSESSSMENT OF HIV- INFECTED
ADULTS AND ADOLESCENTS
• clinical assessment should be carried out to determine existing
conditions which will help in selecting suitable ARV regimen,
such conditions include hepatitis, Tuberculosis, pregnancy,
major psychiatric illness, anemia etc.
• Medical history should also be considered (including traditional
and herbal medication) to avoid drug interaction.
• weight measurement for drug dosages
8. ASSESSMENT CONTINUE…
• patient readiness for therapy
• Hemoglobin measurement if Zidovudine(AZT) is
considered
• pregnancy test if EFV is considered (Efavilins)
• CD4 COUNT cell testing
• Viral load Testing
9. BENEFITS OF STARTING ART TREATMENT
• ART for all HIV infected people is the most effective
prevention method available: Successful ART leads to very
low levels of virus in the blood and in body fluids (viral
suppression).
• There is high treatment coverage and high adherence
• Reduced Viral load in Patients on ART. transmission
• Viral suppression greatly reduces the risk of sexual or
mother-to-child.
10. BENEFITS CONTINUE…
• Earlier initiation and time spend on ART may
provide impetus to shift to less toxic first line
regimen
• Reduces the risks of Tuberculosis and invasive
bacterial diseases due to decline of viral load
11. RISKS OF EARLY INITIATION OF ART
• increases ART cost
• people who urgently in need of the drugs may be displaced by
those who do not need the drug urgently
• early initiation will put someone longer exposure to ART and
may face more ART - Related side effects and ARVS
resistance
• the impact of earlier initiation on adherence is uncertain
12. WHO CLINICAL STAGING OF HIV DISEASE
• The world health organization (WHO) has a method of describing the
different stages of the HIV disease based on clinical symptoms, known as
the WHO staging system for HIV disease.
• It is used when HIV infection has been confirmed by HIV antibody
testing, and it forms part of the baseline assessment on entry into care.
• Untreated HIV infection leads to gradual destruction of the immune
system, leading to different HIV-related diseases
13. CONTI…
• Most of the HIV-related diseases can also occur in HIV negative
patients, but they are more common and more severe in HIV infected
patients.
• Most WHO stage defining conditions apply to all ages ,but some are
only for children under 15years and others are for adults.
• WHO clinical staging requires confirmed HIV infection and is
mandatory for all HIV patients regardless if a CD4 count is available.
14. • HIV-related diseases are grouped into four WHO
clinical stages:
stage 1: Asymptomatic
stage 2: Mild symptoms
stage 3: advanced symptoms
stage 4: severe symptoms
15. WHO CLINICAL STAGING FOR CHILDREN AND
ADULTS WITH CONFIRMED HIV INFECTION
AND DEFINITION OF PRESUMMED SEVERE
HIV DISEASE FOR INFANTS
16. ADULTS AND CHILDREN ADULTS ONLY(15 YEARS OR
OLDER)
CHILDREN ONLY( BELOW 15
YEARS)
1. Asymptomatic
Persistent generalized
lymphadenopathy
2. Respiratory tract
infections,reccurent(sinusitis,
tonsillitis, otitis media,pharyngitis)
Herpes zoster
Angular chelitis
Oral ulcerations, reccurent
Papular prulitic eruptions/fungal
nail infections
Moderate weight loss
<10%,unexplained
Seborrhoeic dermatitis
Hepatosplenomegaly,persistent
unexplained
Lineal gingival erythema
Wart virus infection,extensive
Molluscum contagiosum,extensive
Parotid enlargement,persistent
unexplained
3. Fever, persistent unexplained,
intermittent or constant, >1month
Pulmonary tuberculosis(current)
Tuberculosis(PTB or EPTB) within
the
last 2 years
Anaemia, unexplained <8g/dl
Neutropaenia,unexplained<500/mm
3
Severe weight loss >10% and/or
BMI <18.5kg/m2
Diarrhoea, chronic(>month)
unexplained
Oral candidiasis
Severe bacterial
infections(pneumonia, empyema,
pyomyositis, bone/joint, meningitis,
bacteraemia)
Acute necrotizing ulcerative
Moderate unexplained
wasting/malnutrition not responding
to treatment ( weight for height /age
70-79% or MUAC 11-12mc)
Diarrhoea, persistent unexplained
(14 days or more)
Oral candidiasis (from age 2 months)
Acute necrotizing ulcerative gingivitis
or periodontitis
Lymph node tuberculosis
17. 4. Pneumocystis pneumonia
Candidiasis of oesophagus,
trachea, bronchi or lungs
Extrapulmonary tuberculosis
Kaposi’s sarcoma
HIV encephalopathy
Cryptococcal meningitis or
other
extrapulmonary
cryptococcosis
Disseminated non-
tuberculosis
mycobacterial infection
Cryptosporidiosis, chronic
with
diarrhea
Isosporiasis >1 month
Disseminated mycosis
(coccidiomycoooosis or
histoplasmosis)
Symptomatic HIV-associated
nephropathy or
cardiomyopathy
HIV wasting syndrome(severe
weight loss + persistent fever or
severe weight loss + chronic
diarrhea)
Baacterial pneumonia, recurrent
severe
Chronic herpes simplex infection
(orolabial genital/anorectal >1
month or visceral at any site)
Cytomegalovirus infection
(retinitis or infection of other
organs)
Toxoplasmosis of the brain
Non-typhoidal Salmonella
bacteraemia, recurrent
Invasive cancer of the cervix
Leishmaniasis, atypical
disseminated
Severe unexplained wasting/
malnutrition not responding to
treatment (weight for height/age
<70% or MUAC <11cm or
oedema)
Bacterial infections, severe
recurrent (empyema,
pyomyositis, bone/joint,
meningitis, but excluding
pneumonia)
Chronic herpes simplex infection
( orolabial or cutaneous >1
month or visceral at any site)
Cytomegalovirus infection:
retinitis or other organ (from age
1month)
Toxoplasmosis of the brain (from
age 1 month)
Recto-vaginal fistula, HIV-
associated
Presumed Severe HIV Disease
18. CONTINUE….
• Previously where CD4 testing was not available, the WHO staging
system was being used to determine whether to start
treatment(WHO 2009 treatment guidelines) or not.
• Where a patient is showing signs of WHO clinical stage 3 and 4
they were eligible to start treatment.
• Where a patient is showing signs of WHO clinical stage 1 and 2
they were not eligible to start treatment.
19. IMMUNOLOGICAL ASSESSMENT OF HIV-
INFECTED ADULTS AND ADOLESCENTS
• CD4 counts are the most direct routine measure for HIV immune
suppression.
• A normal CD4 count ranges from 500-1,200cells/mm3 in adults
and adolescents.
• A drop in the CD4 count below 200 cells/mm3 is associated with
a significant increase in opportunistic infections and/or the
disease is progressing.
20. CONTINUE….
• Targeted CD4 count is done to patients with suspected clinical
and/or confirmed treatment failure.
• If CD4 count is <200cells/ml routine urine LAM for disseminated
TB, and serum CrAg for cryptococcal meningitis is done.
• Previously CD4 count was being used to determine on when to
initiate treatment.
• If CD4 is <200cells/mm3 treatment was being initiated
irrespective of clinical stage
21. CONTINUE…..
• If CD4 is 200-350cells/mm3 treatment was being
initiated before CD4 drops below 200
• If CD4 is >350cells/mm3, treatment was not being
initiated on client.
22. VIROLOCICAL ASSESSMENT OF HIV-INFECTED
ADULTS AND ADOLESCENTS
• Viral load (VL) is the number of viral particles per ml of blood.
• Viral load is the measure for the level of progression of HIV
infection.
• It is required to confirm suspected treatment failure.
• Successful treatment leads to low levels of HIV in the blood that
it can no longer be detected with viral load testing.
23. CONTINUE….
• undetectable viral load is also called viral suppression, which is
the aim of treatment
• From the public perspective, the expanded access to viral load
determination should be considered primarily for the diagnosis of
HIV infection in infants and children under 18 months.
24. CONTINUE…
• Currently the affordable methods of determining viral load are
not viable but it is hoped that more affordable methods of
determining viral load ideally to the point of care will be viable
to improve the standard of monitoring for patients on treatment,
especially in situations where treatment switching is being
considered.
25. CONSIDERATIONS FOR TREATMENT ON THE
BASIS OF PUBLIC HEALTH APPROACH
• Countries are encouraged to use public health approach to
support and facilitate wider access to treatment
• Among the key principles of this approach are standardizations
and simplifications of treatment regimens. Therefore it is
suggested that countries select limited number of first-line
regimens and suitable second-line regimens.
26. CONTINUE….
• The use of three ARVs medications is the current
standard treatment for HIV infection in order to achieve
the best possible suppression of viral replication and to
arrest the progression of HIV disease.
27. FACTORS TO BE CONSIDERED WHEN SELECTING
APPROPRIATE TREATMENT REGIMENS FOR PROGRAM
LEVEL:
• 1. Ability to treat all ages
2. Suitability of drug formulation, particularly the availability of
fixed-dose combination
3. licensing approval by national drug regulatory authorities for
the product and the recommended dose.
4. potential for maintenance of future treatment options
28. CONTI…
5. toxicity profile
6. laboratory monitoring requirement
7. promotion of adherence( ARVs taken once daily or twice daily
are well tolerated by clients)
8. special considerations for women of childbearing age and
pregnant women
29. CONTINUE…
9. prevalent coexisting conditions eg tuberculosis, hepatitis b
and c
10. availability from local and intentional manufacturers
11. price and cost-effectiveness
30. CONSTRUCTING THE FIRST LINE REGIMEN
• Regimen are numbered for ease of reference:
• Regimen 4, 5, 6, 13, 14, 15 and 17 are 1st line regimens
• Regimen 13 is the new standard 1st line regimen for males and
females weighing 30kg or above.
• Regimen 0 and 2 have been removed………..
• Regimen 1 and 3 contain stavudine (d4T). They are no longer
used and have been deleted.
31. CONTINUE…
• Regimen 7 – 11 are 2nd line regimens.
• Regimen 12 is the standard 3rd line regimen.
• An “A” is added to the regimen number for adult
formulations (e.g. Regimen 2A) and a “P” is added for
paediatric formulations (e.g. Regimen 2P).
35. HOW DO ARVS WORK
• They prevent multiplication of viruses within the body
TYPES OF ARVs
1. Nucleoside reverse transcriptase inhibitor(NRTIs)
- act by working defective blocks in the production of HIV within the body
2. Non Nucleoside reverse transcriptase inhibitor(NNRIs)
When HIV is multiplying within the body the process requires precise instructions
the medication works by giving Wrong instructions in HIV Manufacturing
36. CONTINUE….
3. Protease inhibitors
• Not most in developing countries.
• This group of medications functions like
preventing HIV from entering the T. cells
37. IMPORTANT POINTS BEFORE ADAPTING THE ARV
REGIMENS BY NATIONS
1. DO NO HARM
• Seek to maintain current progress of treatment programmes
without disrupting the care of those on treatment or
compromising PLHIV at highest risk for poor outcomes.
• 2 Accessibility
• Ensure that all clinically eligible people infected with HIV are
able to enter treatment services.
• .
38. CONTINUE….
• 3 Quality of care
• Ensure that care achieves the highest standards possible
• 4 Equity of access
• Ensure fairness and justice in access to treatment
services.
• 5 Efficiency in resource use
• Aim to achieve the greatest health impact with the optimal
use of available human and financial resources.
40. RECOMMENDATIONS BY WHO
• Strengthen health systems
In making decisions, priority should be given to interventions that
will directly or indirectly strengthen health systems.
• Implement in phases
It may not be possible to implement every new recommendation
in every setting. A phased approach may be necessary if only
some recommendations can be implemented.
41. CONTINUE….
• Understand the perspectives of PLHIV
The toxicity of d4T is of concern to the majority of PLHIV and its
continuing use may undermine confidence in ART. If d4T has to
be included in ongoing regimens, strategies should be devised to
allow for substituting an alternative drug in cases of toxicity.
There should be a plan to eventually avoid the routine use of this
drug.
42. CLASSIFICATION OF ARVS
Mode of action Biochem. structure Abbrev. ARVs Dosing interval
Reverse
Transcriptase
Inhibitors
Nucleosides NRTI
AZT 12-hourly
3TC, ABC
12- or 24hourly
Entecavir (ETV)* 24-hourly
Nucleotide NtRTI TDF 24-hourly
Non-Nucleosides NNRTI
NVP 12-hourly
EFV 24-hourly
Protease Inhibitors PI
ATV/r 24-hourly
DRV 12-hourly
LPV/r 12-hourly
Integrase Strand Transfer
Inhibitor
INSTI
DTG 24-hourly
RAL 12-hourly
43. IMMUNE RECONSTITUTION INFLAMMATORY
SYNDROME (IRIS)
• DEFINITION
• IRIS is an over-aggressive response of the immune system caused by a
sudden recovery on ART.
• A small number of patients may get worse in the first 6 months after
starting ART.
• •
•
•
44. CAUSES
The most common causes for this are (in the order
of likelihood):
• Undiagnosed / untreated OI, mainly TB
• Poor adherence to ART
• Drug-resistant TB (if on TB treatment)
• IRIS
45. CONTINUE…
IRIS appears as a severe bout / worsening of an Opportunistic
Infection:
• TB
• Cryptococcal meningitis
• Herpes zoster
• Kaposis Sacoma
• Hepatitis
46. MANAGEMENT OF IRIS
• Confirm that ART is actually taken as prescribed.
• Continue ART if ART toxicity has been ruled out as the
underlying cause.
• Treat the OI.
• Remember that in case of any CNS infections (e.g.,
cryptococcal and TB meningitis cerebral toxoplasmosis)
ART should be started 5 weeks after initiating treatment of
CNS infection.
47. CONT…
• Consider TB treatment failure if worsening occurs
after more than one month on TB treatment.
• Admit severe cases to hospital.
• NSAIDs may be given in mild and moderate cases.
Consider prednisolone (e.g., 1mg/kg for 2 weeks then
0.5mg/kg for 2weeks) only in severe IRIS.
48. REFFERENCES
DR Mbiri, 2016, Advanced HIV/AIDS, Module, Malawi
Malawi Clinical HIV Guidelines 2021
Malawi comprehensive HIV testing and counselling
training October 2013
National Health research agenda,2012-2016
https://www.aidsmap.com
49. GROUP MEMBERS
1. Agness Gundo BScNM/UP/21/19
2. Richard Mathias BScNM/21/086
3. Anny Simbota BScNM/21/150
4. Ruth Chikweza BScNM/21/019
5. Immaculee Tuyisenge
BScNM/21/155
6. Precious Bulambo BScNM/21/010
7. Daniel Chilombo
BScNM/UP/21/012
8. Mervis Magwaza BScNM/21/078
9. Misheck Khondowe BScNM/21/068
10. Mercy Banda BScNM/21/004
11. Christiana Nthondowa
BScNM/21/127