Summary of recommendations

The table below summarizes the recommendations presented in this guideline. The first recommendation on when to start ART among people living with HIV is subdivided into specific recommendations for adults, pregnant and breastfeeding women, adolescents 10–19 years old, children 1 to less than 10 years old and children younger than 1 year old.

Summary of recommendations in this guideline

Recommendation 1: When to start ART among people living with HIV

Target population Specific recommendation Strength of the recommendation Quality of the evidence
Adultsa
(>19 years)
ART should be initiated in all adults living with HIV at any CD4 cell count Strong Moderate
As a priority, ART should be initiated in all adults with severe or advanced HIV clinical disease (WHO clinical stage 3 or 4) and individuals with CD4 count ≤350 cells/mm3 Strong Moderate
Pregnant and
breastfeeding
women
ART should be initiated in all pregnant and breastfeeding women living with HIV at any CD4 cell count and continued lifelong Strong Moderate
Adolescents
(10–19 years old)
ART should be initiated in all adolescents living with HIV at any CD4 cell count Conditional Low
As a priority, ART should be initiated in all adolescents with severe or advanced HIV clinical disease (WHO clinical stage 3 or 4) and individuals with CD4 count ≤350 cells/mm3 Strong Moderate
Children
(1 to <10
years old)
ART should be initiated in all children 1 to <10 years old living with HIV at any CD4 cell count Conditional Low
As a priority, ART should be initiated among all children <2 years old and those with severe or advanced HIV clinical disease (WHO clinical stage 3 or 4) and individuals with CD4% <25% (if<5 years old) or CD4 count ≤350 cells/mm3 (if ≥5 years old) Strong Moderate
Children
(<1 year old)
ART should be initiated in all children living with HIV younger than 1 year old at any CD4 cell count Strong Moderate