HIV Treatment and Neurodevelopmental Screening

Questions and Answers

What is the recommended action after 2 years of ART initiation in a child?

Switch to a different ART regimen

Do ABCDE assessment and repeat VL after 3 months (correct)

Stop ART and monitor for 6 months

Repeat VL after 6 months

What is the recommended action if a child's viral load is > 1000 after 2 years on ART?

Repeat VL after 6 months

Do ABCDE assessment and repeat VL after 3 months (correct)

Stop ART and monitor for 6 months

Switch to a different ART regimen

What percentage of dispensed ART regimen is considered adequate adherence?

90%

95%

70%

80% (correct)

When should a repeat VL be done to confirm re-suppression in a child on ART?

After 3 months Signup and view all the answers

What is the purpose of neurodevelopmental screening in children on ART?

To identify neurocognitive or developmental delays Signup and view all the answers

What tool is available in the Road To Health Booklet (RTHB) for neurodevelopmental screening?

Neurodevelopmental screening tool Signup and view all the answers

According to the provided guidelines, which antiretroviral regimen is recommended for a child with ABC hypersensitivity?

AZT + 3TC + DTG Signup and view all the answers

When should a clinician switch a child from the 4-in-1 ABC/3TC/LPV/r capsule to ABC + 3TC + DTG?

When the child has a history of poor adherence to the capsule regimen. Signup and view all the answers

What is the recommended frequency for monitoring a child's FBC (Full Blood Count) on AZT?

At months 1, 3, and every 3 months thereafter Signup and view all the answers

What action should be taken if a child on AZT has a hemoglobin level of 7.5 g/dL?

Switch to a different antiretroviral regimen Signup and view all the answers

What is the primary purpose of the baseline laboratory evaluation mentioned in the guidelines?

To establish a baseline for monitoring the child's response to ART Signup and view all the answers

Which of the following is NOT a reason to switch a child from LPV/r or ATV/r to a different regimen?

Elevated liver enzymes Signup and view all the answers

What is the recommended action if a child on AZT has a neutrophil count persistently below 1000 cells/µL?

Switch to a different antiretroviral regimen Signup and view all the answers

What is the primary purpose of monitoring viral load in children receiving ART?

To determine the effectiveness of the antiretroviral regimen Signup and view all the answers

What is the specified ART regimen for children weighing between 3 kg to less than 30 kg?

ABC + 3TC + DTG Signup and view all the answers

When should clinical assessments for children under 5 years be conducted?

On week 14, month 12, and every 12 DC intervals Signup and view all the answers

Which medication combination is prescribed for neonates from birth to less than 4 weeks of age?

AZT + 3TC + NVP Signup and view all the answers

What should be monitored during clinical assessments for children under 2 years of age?

Weight, head circumference, and neurodevelopment Signup and view all the answers

What is the viral load threshold that is considered a medical emergency?

≥ 50 Signup and view all the answers

What is the pediatric dosing concentration for Lamivudine (3TC)?

10 mg/mL Signup and view all the answers

When should ART be initiated for a child with a weight of 4 kg?

Immediately after diagnosis Signup and view all the answers

What should be assessed during the routine monitoring of a child's health on ART?

Neurodevelopment and adherence to treatment Signup and view all the answers

When are the routine viral load checks scheduled for a child under ART?

DC/mont 3, 10, and every 12 DCs thereafter Signup and view all the answers

What is the dosing formulation of Zidovudine (AZT) for pediatric use?

10 mg/mL Signup and view all the answers

Study Notes

Individualized Regimen Recommendations

Individualized regimen advised by HIV experts is essential for effective treatment.
Achieve over 80% adherence to therapy to ensure viral load re-suppression.
Viral load (VL) should be rechecked after 3 months to confirm sustained re-suppression.

Neurodevelopmental Screening

Utilize the Road To Health Booklet as a screening tool for neurodevelopmental assessments.
Identify any neurocognitive or developmental delays in clients.

Laboratory Evaluations and Actions

Initial laboratory evaluations are critical for clients starting ART.
If a client has a previous VL > 1000 after 2 years on LPV/r or ATV/r, perform an ABCDE assessment.
Repeating VL after 3 months helps categorize client status concerning adverse events related to ART.

Adverse Events and Testing Frequency

For patients on specific drugs, regular testing is required to monitor health.
AZT (Zidovudine) patients need FBC and differential testing at 1 and 3 months.
Interpret results: Hb ≥ 8 g/dL allows continuation of AZT; Hb < 8 g/dL necessitates consultation for alternative therapy.

Confirming HIV Test Results

Follow the national testing algorithm strictly to confirm HIV diagnosis.
Special attention required for patients weighing ≥ 3 kg to < 30 kg and aged ≥ 4 weeks to < 10 years.
For neonates (birth to < 4 weeks), formula AZT + 3TC + NVP is used after confirming eligibility.

ART Regimens for Specific Groups

AZT + 3TC + DTG designated dosing per pediatric dosing chart.
Regimen for neonates includes AZT + 3TC + NVP at specified dosages.

Monitoring and Clinical Assessment

Conduct clinical assessments during every patient visit for growth metrics (height, weight, head circumference).
Adjust ART dosage based on weight for patients under 2 years.
Regular inquiries about potential side effects are necessary to ensure patient safety.

Importance of Viral Load Monitoring

A viral load ≥ 50 indicates a medical emergency that requires immediate attention.
Continuous monitoring helps in managing ART effectiveness and patient outcomes.

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Description

Quiz about individualized regimen recommendations for HIV treatment and neurodevelopmental screening tools, such as the Road To Health Booklet.