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1 When to Start ARV Therapy

  • ARV therapy should be offered to all HIV-infected individuals regardless of their CD4 cell count, except elite controllers (pVL consistently <250 copies/mL without ARV therapy)
  • It is important to confirm that the patient is ready to commit to life-long therapy with a very high level of adherence

Should my patient start ARV therapy?

  • What is the nature of the HIV infection?
    • Acute or primary infection
    • Chronic infection
  • Is the patient symptomatic?
    • Symptomatic
    • Asymptomatic
  • What is the patient's pVL?
    • Consistently <250 copies/mL
    • ≥250 copies/mL on 2 consecutive readings
  • Start ARV Therapy
  • Treatment can be deferred
  • Offer ARV Therapy

§ 2 Which Regimen to Start →