A familiar scenario is an hiv proven pregnant women and accompanying problems in management
Revised guidelines on What to start in ART naive patients
November 2104
Instructions on use of single pill of Tenofovir + Lamivudine + Efavirenz
- All new patients being initiated on ART, irrespective of Hb level, to be initiated on single pill of TLE at bed time, 2-3 hours after dinner and fatty food to be avoided as far as possible
- To shift all patients presently on TL+N and TL+E separate pills to this combination of TLE in single pill
- Those patients who are on TL+E, due to concomitant ATT, will not be changed to NVP after ATT is completed (which is existing practice) Stop using TL with separate NVP or EFV as soon as you receive this single pill FDC of TLE . SACS to
- send TLE single pill to all centres as soon as they get it
- This TL available with centres or SACS needs to be kept for second line patients, patients with NNRTI intolerance, women with h/o single dose NVP in the past, HIV-2 or HIV 1&2 co-infected patients with Hb <9 gm% and separate NVP has to be kept only for those who cannot tolerate EFV
- There are some apprehensions about side effects of EFV. There is nothing to worry. Our experience has shown these side effects to be minimal and these subside in most patients in 7-21 days. We should give adequate time for these side effects to settle down and do not change regimen in a hurry. The MO has to train the counsellor adequately on this issue
Superintendent, ICH.