The new National Consolidated Guidelines for the Prevention of Mother-to-Child Transmission of HIV (PMTCT) and the Management of HIV in Children, Adolescents and Adults from the Department of Health were released in December 2014.

There are a number of changes from the previous guidelines, not least the fact that it is a consolidated guideline. This means the testing, care and treatment of children, adolescents and adults (including PMTCT) are all included).

These are some of the main updates:

• Initiation of ART in all adults and children > 5 years old with CD4 < 500
• ART in all patients co-infected with hepatitis B or TB, regardless of CD4
• Pregnant, breastfeeding and within one year post-partum, HIV-positive women: immediate initiation on LIFELONG ART, regardless of CD4 count
• EFV is being used throughout all trimesters of pregnancy
• VL testing for women on ART > 3 months at pregnancy confirmation, to direct treatment
• Birth HIV PCR for all neonates at high risk
• Third-line drugs for patients failing second-line 

These are just some of the updates in the new guidelines. Click here for a printable version of the full guidelines on the DoH website.