TABLE 1.

South African guidelines for treatment of adults with human immunodeficiency virus infection.

Variable	2004 guidelines	April 2010 guidelines	March 2013 guidelines†	December 2014 guidelines‡	August 2016 circular‡
ART eligibility	CD4 count < 200 cells/mm3 or WHO Stage IV disease	CD4 count ≤ 200 cells/mm3 or CD4 count ≤ 350 cells/mm3 in clients with TB/HIV or pregnant women or WHO stage IV disease or MDR/XDR-TB	CD4 count ≤350 cells/mm3¶ or WHO stage III or IV disease or Clients with all types of TB	CD4 count ≤ 500 cells/mm3 or WHO stage III or IV disease or Active TB disease or Pregnant and breastfeeding women or Known HBV co-infection	UTT: all HIV-infected clients regardless of CD4 count
First-line ART regimen (new clients)	d4T + 3TC + EFV/NVP	TDF + 3TC/FTC + EFV/NVP	FDC††	FDC††
CPT	All clients initiating ART	CD4 ≤ 200 cells/mm3 WHO stage II, III or IV disease (including TB)		CD4 count ≤ 200 cells/mm3 WHO stage III or IV disease HIV/TB co-infection

Source: National Department of Health of South Africa^5,6,7,8,9

3TC, lamivudine; ART, antiretroviral therapy; CPT, cotrimoxazole preventive therapy; d4T, stavudine; EFV, efavirenz; FDC, fixed-dose combination; FTC, emtricitabine; HIV, human immunodeficiency virus; HBV, hepatitis B; MDR/XDR-TB, multidrug-resistant or extensively drug-resistant tuberculosis; NVP, nevirapine; TB, tuberculosis; TDF, tenofovir disoproxil fumarate; UTT, universal test and treat; WHO, World Health Organization

^†, Implementation date = 01 April 2013;

^‡,Implementation date = 01 January 2015;

^‡, Implementation date = 01 September 2016;

^¶, Implementation of the CD4 count ≤350 cell/mm³ cut-off occurred in August 2011, prior to the publication of the 2013 guidelines¹⁰;

^††, FDC consists of TDF, FTC and EFV.