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4. Start ART:• Give 3 ARVs from table below according to chosen ART regimen 63. If starting regimen 1, give fixed dose combination (FDC) TDF/FTC/EFV 1 tablet daily if available.• Delay ART and refer to doctor if blood results abnormal 63, poor adherence, TB symptoms or depression or psychosis.Antiretroviral Dose Frequency If eGFR < 50 Side effects (refer if "self-limiting" side-effects persist after 6 weeks)Lamivudine (3TC) 150mg 12 hourly eGFR 10–50: 150mg daily Uncommon300mg Once daily eGFR < 10: 50mg dailyTenofovir (TDF) 300mg Once daily Avoid TDF Nausea, vomiting, diarrhoea, kidney failureStavudine (d4T) 30mg 12 hourly eGFR 10–50: 15mg 12 hourly Lactic acidosis 62, burning toes, body shape change (switch to TDF)eGFR < 10: 15mg dailyZidovudine (AZT) 300mg 12 hourly eGFR < 10: 300mg daily Lactic acidosis, vomiting, nausea (self limiting, take with food), headache, fatigue(self limiting, if Hb < 7 62), body shape change (switch to TDF)Emtricitabine (FTC) 200mg Once daily UncommonEfavirenz (EFV) 600mg 24 hourly - the same time every night Same dose Dizziness, sleep problems, depression (all self limiting), gynaecomastiaNevirapine (NVP) 200mg Once daily for 2 weeks, then 12 hourly to reducerisk of skin rash and hepatitis.Same doseSkin rash, nausea (self limiting, take with food), abdominal pain, jaundice or vomitingmay be hepatitis – advise patient to return urgently and refer same day.Lopinavir/ritonavir (LPV/r)400/100mg2 tablets12 hourly. On TB treatment, doctor to double dosegradually.Same doseDiarrhoea, change in body shape (switch to TDF). If also on TB treatment, abdominal pain,jaundice or vomiting may be hepatitis – refer same day.5. Decide when to review the HIV patient on ART:• If pregnant: review patient and baseline blood results 1 week after starting ART, and then monthly.• If not pregnant: review 2 weeks after starting ART, then monthly until stable.• If stable (patient has CD4 > 350, VL < 400, normal routine ART blood results, is adherent and well on ART): review 3 monthly.6. Decide when to stop the following treatments in the HIV patient:• Co-trimoxazole: stop after 1 year if CD4 > 200 and patient well on ART.• Fluconazole for cryptococcal meningitis: stop after 1 year if CD4 > 200 and patient well on ART.• Pyridoxine: Stop when patient finishes TB treatment or isoniazid preventive therapy.• Maternal ART prophylaxis in the mother with baseline CD4 >350 and stage 1 or 2:--Check stage, hepBsAg, and CD4 result from past 12 months.--Stop ART 1 week after last breastfeed if still stage 1 or 2, hepBsAg negative and CD4 > 350.• Nevirapine in the baby exposed to HIV: 97.• IPT: stop isoniazid depending on baseline TST 1 result and if on ART:TST 1 not doneTST 1 negative < 5mmTST 1 positive ≥ 5mmCD4 > 350, not on ARTOn ARTStop IPT after 6 months. Stop IPT after 12 months. Stop IPT after 36 months.1Tuberculin Skin Test (Mantoux ® )HIV64