Table 1. National Guidelines for ART eligibility for HIV seropositive children age ≤ 15 years from 2005 to 2016, Myanmar.
| Guidelines | ART eligibility criteria | Preferred ART regimen |
|---|---|---|
| National Guidelines | • WHO Stage 4 or 3 | AZT or d4T +3TC+NVP or EFV (if age >3 years) |
| [Guideline 2005] | • Age ≤18 months, WHO Stage 1 or 2 with TLC <2500mm3 | |
| • Age >18 months, WHO Stage 1 or 2 with TLC <1500mm3 | ||
| • If CD4 cell counts are available, then | ||
| ○ Age ≤18 months, any WHO Stage (1/2/3/4) with % CD4 <20% | ||
| ○ Age >18 months, any WHO Stage (1/2/3/4) with % CD4 <15% | ||
| National Guidelines | • WHO Stage 3 or 4 | AZT or d4T +3TC+NVP or EFV (if age >3 years) |
| [Guidelines 2007] | • CD4 indicating severe HIV associated immune deficiency | |
| ○ Age <11 months with CD4 <25% | ||
| ○ Age 12–35 months with CD4 <20% | ||
| ○ 36–59 months with CD4 <15% | ||
| ○ ≥5 years with CD4 <15% or CD4 Cell count <200 cells/mm3 | ||
| National Guidelines | • All HIV infected children less than 2 years | If age < 2 years |
| [Guidelines 2011] | • For children > 2 years, if WHO Stage 3 or 4 | • AZT+3TC+NVP for NVP naïve children |
| • For children > 2 years, and WHO Stage 1 or 2 if | • AZT+3TC+LPV/r for NNRTI exposed children | |
| ○ Age 2 to 5 years and CD4 cell count ≤750 cells/mm3 | If age 2 to 3 years—> | |
| ○ Age >5 years and CD4 cell count ≤ 350 cells/mm3 | • AZT or ABC or d4T+3TC+NVP | |
| If age > 3 years | ||
| • AZT or ABC or d4T+3TC+NVP or EFV | ||
| National Guidelines | • All HIV infected children age ≤ 5 years | If age <3 years (any of the two regimens) |
| [Guideline 2014] | • For children > 5 years, if | • ABC or AZT+3TC+LPV/r |
| ○ CD4 cell count ≤ 500cells/mm3; | • ABC or AZT+3TC+NVP | |
| ○ WHO Stage 3 or 4 | If age 3 to 10 years (any of the four regimens) | |
| ○ HIV-TB co infection | • ABC+3TC+EFV | |
| • ABC or AZT+3TC+NVP | ||
| • TDF+3TC+NVP or EFV | ||
| • AZT+3TC+EFV | ||
| If age 10 to 19 years (any of the 3 regimens) | ||
| • TDF+3TC+EFV | ||
| • AZT+3TC+EFV or NVP | ||
| • TDF+3TC+NVP |
ART = Anti-retroviral therapy; HIV = Human immunodeficiency virus (HIV); TLC = Total Leucocyte count; WHO = World Health Organisation; ABC = Abacavir; AZT = Zidovudine; d4t –Stavudine; EFV = Efavirenz;, LPV/r-lopinavir boosted ritonavir; NVP = Nevirapine; TDF-Tenofovir disoproxil fumarate; 3TC-lumivudine