TABLE 18.

Standard laboratory monitoring of patients after commencement of antiretroviral therapy.

Test†	When		Comments
	Baseline	Ongoing
VL	Yes	At 3 months, 6 months and then 6 monthly	If VL undetectable for > 12 months, can reduce to 12 monthly
CD4+ count	Yes	6 monthly At virological/clinical failure	Can be stopped if CD4+ > 200 cells/µL and virologically suppressed
FBC + differential count	Yes	Monthly for the first 3 months, then at 6 months	For patients on AZT-containing regimens
ALT	Yes	At initiation	If baseline ALT is normal, routine monitoring of ALT is not required
CrCl	Yes	At 3 months, 6 months and then 6 monthly	Also at 1 and 2 months in high-risk patients. If symptoms of tubular wasting (e.g. muscle weakness), then check potassium and phosphate levels
TC and TG	Not routinely	After 3 months on a PI-containing regimen	If normal at 3 months, reassess only if other cardiovascular risk factors are present

ALT, alanine transaminase; AZT, zidovudine; CrCl, creatinine clearance rate; FBC, full blood count; NVP, nevirapine; TC, total cholesterol; TG, triglycerides; VL, viral load; PI, protease inhibitor; CD4⁺, cluster of differentiation 4.

^†, These tests should also be performed when clinically indicated, based on the discretion of the clinician.