🩺 General MedicineInfectiousStudentInternResident

HIV & Antiretroviral Therapy

Also known as: HIV · AIDS · ART · antiretroviral therapy

HIV is a chronic, manageable infection. 'Test and treat' — start antiretroviral therapy in everyone diagnosed, regardless of CD4 — restores immunity and prevents transmission (undetectable = untransmittable).

Source · Reviewed 2026-08-15 · v1.0— AI-assisted draft — verify against the current NACO/WHO guideline before clinical use.

⚕️ Education only — not medical advice. Verify against the latest official guideline and your local protocol; confirm every drug dose against the cited source before clinical use.

Who gets it

Anyone; transmission via unprotected sex, blood, and mother-to-child. Test people with risk factors, TB, STIs, in pregnancy, and with indicator conditions.

Red flags — escalate / refer

Advanced disease / opportunistic infection (TB, cryptococcal meningitis, PCP) or a very low CD4 → manage the infection and start prophylaxis.
Watch for immune reconstitution inflammatory syndrome (IRIS) after starting ART.

Work-up / diagnosis

1Confirm HIV per the national testing algorithm.
2Baseline CD4 count and (where available) viral load; screen for TB, hepatitis B/C, STIs and pregnancy.
3Assess for opportunistic infections before/at ART start.

Management — overview

Start ART in everyone (test-and-treat), ideally soon after diagnosis — but treat active opportunistic infections (e.g. TB, cryptococcal meningitis) appropriately first/alongside.
Use the national first-line regimen (a dolutegravir-based combination is preferred).
Give co-trimoxazole prophylaxis in advanced disease and TB preventive therapy where indicated.
Support adherence, monitor viral load, and prevent mother-to-child transmission in pregnancy.

In-depthFull dosing & advanced protocol

Drug dosing

First-line ART (TLD)

Preferred first-line regimen

Adult dose: Tenofovir + lamivudine + dolutegravir, one tablet once daily
Route: Oral

Caution: Screen for TB before/at ART start; check interactions (e.g. rifampicin) and watch for IRIS.

NACONACO, India — National Guidelines for HIV Care & Antiretroviral Therapy ↗

Co-trimoxazole prophylaxis

Advanced HIV / low CD4

Adult dose: Daily, per guideline
Route: Oral

WHOWHO Model List of Essential Medicines (electronic EML) (2025 (24th)) ↗

OIs, IRIS & prevention

Sequence ART with opportunistic-infection treatment (e.g. start ART early in most OIs, but delay in cryptococcal/TB meningitis to reduce IRIS harm) per guidance.
Prevention: PMTCT in pregnancy, and PrEP/PEP for at-risk HIV-negative people.
Monitor viral load to confirm suppression and detect treatment failure; manage drug interactions.

NACONACO, India — National Guidelines for HIV Care & Antiretroviral Therapy ↗

References

Guidelines change. If something here is out of date, tell us — we keep these current.

🚩 Report outdated / suggest update

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👤 Who gets it

🚩 Red flags — escalate / refer

🔎 Work-up / diagnosis

🧭 Management — overview

💊 Drug dosing

First-line ART (TLD)

Co-trimoxazole prophylaxis

📈 OIs, IRIS & prevention

📚 References

More protocols

👤 Who gets it

🚩 Red flags — escalate / refer

🔎 Work-up / diagnosis

🧭 Management — overview

💊 Drug dosing

First-line ART (TLD)

Co-trimoxazole prophylaxis

📈 OIs, IRIS & prevention

📚 References

More protocols

Who gets it

Red flags — escalate / refer

Work-up / diagnosis

Management — overview

Drug dosing

OIs, IRIS & prevention

References

Who gets it

Red flags — escalate / refer

Work-up / diagnosis

Management — overview

Drug dosing

OIs, IRIS & prevention

References