Clinical Guidelines for The Management of HIV & AIDS in Health Facilities

South Africa's national HIV treatment guidelines document was published in 2008. This document presents a national approach that integrates the principles of ART for adults, adolescents, children and pregnant women. Treatment criteria for adults include CD4 counts below 250; clinical stage 4 of the disease or in presence severe HIV-related conditions or co-morbidity such as Immune Thrombocytopenic Purpura and Thrombotic Thrombocytopenic Purpura, Severe manifestations of the diffuse infiltrative lymphocytic syndrome (e.g.  lymphocytic interstitial pneumonitis, polymyositis), MDR or XDR tuberculosis, Severe hidradenitis suppurativa, non-HIV-related metastatic or disseminated malignancies. Infants and children with CD4 counts based on advanced or “severe” immune suppression, as defined by age-related CD4 percentage are also eligible for treatment. These guidelines also recommend a second treatment option should first line treatment fail. Extensive management of opportunistic infections, post-exposure and cotrimoxazole prophylaxis, co-infection with TB are also included in this document.