HIV infection is not the end of life. People can lead a healthy life for a long time with appropriate medical care. Anti-retroviral therapy (ART) effectively suppresses replication, if taken at the right time. Successful viral suppression restores the immune system and halts onset and progression of disease as well as reduces chances of getting opportunistic infections – this is how ART is aimed to work. Medication thus enhances both quality of life and longevity.
Adherence to ART regimen is therefore very vital in this treatment. Any irregularity in following the prescribed regimen can lead to resistance to HIV drugs, and therefore can weaken or negate its effect.
ART is now available free to all those who need it. Public health facilities are mandated to ensure that ART is provided to people living with HIV/AIDS (PLHA). Special emphasis is given to the treatment of sero-positive women and infected children.
|WHO Clinical Staging||Recommendations|
|HIV Infected Adults & Adolescents|
|Clinical Stage I and II||Start ART if CD4 ≤ 500|
|Clinical Stage III and IV||Start ART irrespective of CD4 count|
|All Pregnant / Breast Feeding Women|
|All clinical Stages||Start ART irrespective of CD4 count|
|HIV-TB Co-Infected Patients|
|Patients with HIV and TB co-infection|
(Pulmonary or Extra Pulmonary)
|Start ART irrespective of CD4 count|
Start ATT first, initiate ART as early as possible between 2 weeks-2months.For patients with CD4 below 50, ART might be initiated simultaneously with ATT with strict clinical and laboratory monitoring
|HIV-Hepatitis B/C Co-Infected Patients|
|HIV and HBV / HCV co-infection – without any evidence of severe chronic liver disease||Start ART if CD4 ≤ 500|
|HIV and HBV / HCV co-infection – with evidence of severe chronic liver disease||Start ART irrespective of CD4 count|
|HIV-Visceral Leishmaniasis (KalaAzar) Co-Infected Patients|
|Patients with HIV-Visceral Leishmaniasis co-infected||Start ART irrespective of CD4 count|
There are 528 ART centres operating in the country as of 17th October, 2016.
In order to make treatment more accessible ART centres are located in medical colleges, district hospitals and non-profit charitable institutions providing care, support and treatment services to PLHA. A PLHA network person at each of the ART centre facilitates access to care and treatment services at these centres. ART centres also provide counselling and follow up on treatment adherence and support through community care centres.
The primary goal of paediatric prevention, care and treatment programme is to prevent HIV infection to newborns through Prevention of Parent to Child Transmission (PPTCT) and provide treatment and care to all children infected by HIV.