Antiretroviral drugs have their own side effects and while a child is on ART, screening for drug toxicity and adverse effect is essential. Child also has to be monitored for clinical, immunological and virological improvement. Thus apart from serial CD4, viral load monitoring, regular screening of hemogram, liver function tests, lipid profile and pancreatic enzymes is essential and ensuring correct dosage of ART.
Monitoring would consist of :
- Clinical assessment monthly/trimonthly
- Complete blood count minimum 6 monthly
- CD4 count 3 monthly
- HIV viral load 3 monthly
- Blood biochemistry (Liver function tests, renal function tests, pancreatic enzymes, blood sugar, lipid profile) 3 monthly.
With initial start of therapy, the child may need to be monitored every 15 days to look for adverse effects, development of immune reconstitution (IRIS) and if on NNRTI to check for Steven Johnson syndrome. Once the child is doing fine, he may be followed up 3 monthly.
