Treatment Medicines
Antiretroviral Therapy (ART)
ART rebuilds the immune system and is recommended for everyone with AHD. WHO recommends rapid initiation within 7 days of diagnosis, including same-day ART where no contraindications exist. Dolutegravir (DTG)-based regimens remain the preferred option for initial and subsequent treatment. ART should be delayed if TB meningitis or cryptococcal meningitis is suspected: delay 4 weeks after starting TB treatment for TB meningitis, or 4–6 weeks after starting treatment for cryptococcal meningitis, to reduce the risk of life-threatening immune reconstitution inflammatory syndrome (IRIS).
Liposomal Amphotericin B + Flucytosine + Fluconazole
First-line treatment for cryptococcal meningitis. WHO’s preferred induction regimen is a single high dose (10 mg/kg) of liposomal amphotericin B on day 1, combined with 14 days of flucytosine and fluconazole. This is followed by 8 weeks of fluconazole 800 mg, then a reduced maintenance dose of 200 mg/day until CD4 is above 200 cells/mm³.
Resources & Tools
Training Materials
TB Therapy (RIPE / paediatric fixed-dose combinations)
For confirmed or presumptive tuberculosis. The standard regimen is a four-drug combination: rifampicin, isoniazid, pyrazinamide, and ethambutol. Child-friendly dispersible fixed-dose combinations are available for children, reducing pill burden and improving adherence.
Resources & Tools
Training Materials
Ceftriaxone (or other antibiotics per local guidelines)
For severe bacterial infections. Empirical antibiotic treatment should be started promptly in seriously ill patients showing danger signs (respiratory rate ≥30/min, heart rate ≥120/min, unable to walk unaided), based on local antimicrobial guidelines.