Tenofovir + lamivudine + dolutegravir (TLD, first-line), Cotrimoxazole (prophylaxis: CD4 < 350 or WHO stage 3–4), TB preventive treatment (after excluding active TB)
Advice and when to refer
Refer to the ART centre: Start ART the same day or within 7 days, after baseline CD4, HBsAg, HCV, VDRL, creatinine, TB symptom screen, and CrAg if CD4 < 200 (NACO 2021)
Viral load: At 6 and 12 months, then yearly; aim undetectable (failure if ≥ 1000 copies/mL) (NACO 2021; WHO 2021)
Investigations
Baseline tests at the ART centre; start ART the same day or within 7 days — tests must not delay it.
First visit
CD4 count — Baseline.
CBC, creatinine, LFT, blood glucose — Baseline before tenofovir and dolutegravir.
HBsAg and anti-HCV — Co-infection changes the regimen.
VDRL/RPR — Syphilis screening.
TB symptom screen and chest X-ray — Every visit; sputum NAAT if any symptom.
Urine pregnancy test — Women of child-bearing age.
Only if indicated
Serum cryptococcal antigen — CD4 under 200 cells/µL.
Follow-up and monitoring
Viral load — At 6 and 12 months, then yearly; 1000 copies/mL or more on two tests 3 months apart is failure.
Creatinine — Yearly on tenofovir (more often if diabetic or hypertensive).
Locked
The adult dose for each drug
The child dose, where the card gives one
Indian brand names for each drug, with a link to buy
ICU Decoded — original critical-care and internal-medicine pathways by
Dr Javed Akhtar, each cited to a current guideline. For education and quick
reference; verify every dose against local protocols before prescribing.