Box 2. Summary of adolescent‐specific 2016 WHO recommendations
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1. When to start ART in adolescents: |
ART should be initiated in all adolescents living with HIV regardless of WHO clinical stage and at any CD4 count.
[conditional recommendation, low‐quality evidence]
As a priority ART should be initiated in all adolescents with severe or advanced HIV clinical disease (WHO clinical stage 3 or 4) and adolescents with a CD4 count ≤ 350 cells/mm3. [strong recommendation, moderate‐quality evidence]
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2. First‐line ART for adolescents: |
First‐line ART for adolescents should consist of two nucleoside reverse transcriptase inhibitors and a non‐nucleoside reverse transcriptase inhibitor or an integrase inhibitor.
[strong recommendation, low‐quality evidence]
TDF + 3TC (or FTC) + EFV as a fixed‐dose combination is recommended as the preferred option to initiate ART
[strong recommendation, low‐quality evidence]
TDF + 3TC (or FTC) + DTG or TDF + 3TC (or FTC) + EFV400 may be used as alternative options to initiate ART
[conditional recommendation, low quality evidence]
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3. Adolescent‐friendly health services: |
Adolescent‐friendly health services should be implemented in HIV services to ensure engagement and improved outcomes [strong recommendation, low‐quality evidence]
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