HIV/AIDS — Uganda (General Adult population)
Test and Treat Policy
Provide lifelong antiretroviral therapy (ART) to ALL people living with HIV irrespective of CD4 count or clinical staging. Initiate ART on the same day if client is ready, or within 7 days for children/pregnant women, and within 1 month for adults.
First-Line ART (Adults, Adolescents >30kg, Pregnant/Breastfeeding)
Preferred: TDF + 3TC + DTG. Alternative if DTG contraindicated: TDF + 3TC + EFV400. Alternative if TDF contraindicated: TAF + FTC + DTG. Alternative if TDF/TAF contraindicated: ABC + 3TC + DTG.
First-Line ART (Children ≥20kg to <30kg)
Preferred: ABC + 3TC + DTG. Alternative if DTG contraindicated: ABC + 3TC + LPV/r (tablets). Alternative if ABC contraindicated: TAF + FTC + DTG (for children >6 years and >25kg).
First-Line ART (Children <20kg)
Preferred: ABC + 3TC + DTG. Alternative if intolerant or appropriate DTG formulations unavailable: ABC + 3TC + LPV/r Granules. Alternative if intolerant to LPV/r: ABC + 3TC + EFV (in children >3 years and >10kg).
Monitoring of ART
Schedule of visits: 1, 2, and 3 months from start of ART, then at 6, 9, 12 months. After 12 months, stable patients follow Differentiated Model of Care Delivery.
Drug Interactions — Rifampicin
Rifampicin lowers DTG levels. Action: Adjust DTG dose to twice daily. Do NOT co-administer Nevirapine (NVP) and rifampicin. If given with LPV/r, increase dose of RTV to achieve 1:1 ratio.
Drug Interactions — Oral Contraceptives / Implants
EFV, ATV/r, LPV/r, DRV, RTV increase metabolism of contraceptives. Action: Use additional barrier method or use Depo-Provera or IUDs.
Drug Interactions — Anticonvulsants (Carbamazepine, Phenytoin, Phenobarbital)
Decrease DTG levels by 30-70%. Action: Use valproic acid instead.
Drug Interactions — Metformin
DTG increases metformin levels (risk of hypoglycaemia/metabolic acidosis). Action: Close follow-up of electrolytes, BUN, Creatinine, RBS.
Related Clinical Tools
