Questions | Concepts | |
|---|---|---|
What do you want to do? 🔘 Start ART 🔘 Substitute ART Regimen 🔘 Switch ART Regimen Line 🔘 Stop ART 🔘 Restart ART therapy | ||
Start ART | ||
Date of ART initiation ␣␣-␣␣-␣␣␣␣ 📆 | 15959 9Antiretroviral 159599 Antiretroviral treatment start date | |
Regimen line *** 🔽 Adult 1st line ARV regimen 🔽 Child 1st line ARV regimen | 164515 ARV regimen or code patient is switched toRegimen *** | |
Regimen 🔽 ABC + 3TC + ATVr 🔽 ABC + 3TC + DRV+RTV+RAL 🔽 ABC + 3TC + DRVr 🔽 ABC + 3TC + DTG 🔽 ABC + 3TC + EFV 🔽 ABC + 3TC + LPV/r 🔽 ABC + 3TC + NVP 🔽 ABC + 3TC + RAL 🔽 AZT + 3TC + ATV/r 🔽 AZT + 3TC + DRV + RTV + RAL 🔽 AZT + 3TC + DTG 🔽 AZT + 3TC + EFV 🔽 AZT + 3TC + LPV/r 🔽 AZT + 3TC + NVP 🔽 AZT + 3TC + RAL 🔽 d4T + 3TC + EFV 🔽 d4T + 3TC + LPV/r 🔽 d4T + 3TC + NVP 🔽 ETV + 3TC + DRV + RTV 🔽 RAL + 3TC + DRV + RTV 🔽 RAL + 3TC + DRV + RTV + ABC 🔽 RAL + 3TC + DRV + RTV + AZT 🔽 RAL + 3TC + DRV + RTV + TDF 🔽 TAF + 3TC + DRV/r 🔽 TAF + 3TC + DTG 🔽 TAF + 3TC + LPV/r 🔽 TDF + 3TC + DTG + DRV + RTV 🔽 TDF + 3TC + DTG + ETR + DRV + RTV 🔽 TDF + 3TC + EFV 🔽 TDF + 3TC + LPV/r 🔽 TDF + 3TC + NVP 🔽 TDF + FTC + DTG 🔽 TDF + FTC + EFV | 164432 ARV regimen/code for drugs collected | |
Switch ART Regimen Line | ||
Date regimen line switched ␣␣-␣␣-␣␣␣␣ 📆 | ||
Reason for switching regimen line 🔘 Virologic failure 🔘 Immunologic failure | 160568 Reason antiretrovirals changed to second line therapy | |
Regimen line 🔽 Adult 2nd line ARV regimen 🔽 Child 2nd line ARV regimen | ||
Regimen *** 🔽 ABC + 3TC + ATVr 🔽 ABC + 3TC + DRV+RTV+RAL 🔽 ABC + 3TC + DRVr 🔽 ABC + 3TC + DTG 🔽 ABC + 3TC + EFV 🔽 ABC + 3TC + LPV/r 🔽 ABC + 3TC + NVP 🔽 ABC + 3TC + RAL 🔽 AZT + 3TC + ATV/r 🔽 AZT + 3TC + DRV + RTV + RAL 🔽 AZT + 3TC + DTG 🔽 AZT + 3TC + EFV 🔽 AZT + 3TC + LPV/r 🔽 AZT + 3TC + NVP 🔽 AZT + 3TC + RAL 🔽 d4T + 3TC + EFV 🔽 d4T + 3TC + LPV/r 🔽 d4T + 3TC + NVP 🔽 ETV + 3TC + DRV + RTV 🔽 RAL + 3TC + DRV + RTV 🔽 RAL + 3TC + DRV + RTV + ABC 🔽 RAL + 3TC + DRV + RTV + AZT 🔽 RAL + 3TC + DRV + RTV + TDF 🔽 TAF + 3TC + DRV/r 🔽 TAF + 3TC + DTG 🔽 TAF + 3TC + LPV/r 🔽 TDF + 3TC + DTG + DRV + RTV 🔽 TDF + 3TC + DTG + ETR + DRV + RTV 🔽 TDF + 3TC + EFV 🔽 TDF + 3TC + LPV/r 🔽 TDF + 3TC + NVP 🔽 TDF + FTC + DTG 🔽 TDF + FTC + EFVdfbe256e-30ba-4033-837a-2e8477f2e7cd | 164432 ARV regimen/code for drugs collected | |
Substitute ART Regimen | ||
Date regimen substituted ␣␣-␣␣-␣␣␣␣ 📆 | ||
Reason for substituting regimen 🔽 New diagnosis of Tuberculosis 🔽 Currently pregnant 🔽 Medications unavailable 🔽 Toxicity, drug 🔽 Other non-coded | 160562 Reason antiretrovirals changed for first line therapy | |
Regimen line 🔽 Adult 1st line ARV regimen 🔽 Adult 2nd line ARV regimen 🔽 Child 1st line ARV regimen 🔽 Child 2nd line ARV regimen | 164515 ARV regimen or code patient is switched toRegimen *** | |
Regimen 🔽 ABC + 3TC + ATVr 🔽 ABC + 3TC + DRV+RTV+RAL 🔽 ABC + 3TC + DRVr 🔽 ABC + 3TC + DTG 🔽 ABC + 3TC + EFV 🔽 ABC + 3TC + LPV/r 🔽 ABC + 3TC + NVP 🔽 ABC + 3TC + RAL 🔽 AZT + 3TC + ATV/r 🔽 AZT + 3TC + DRV + RTV + RAL 🔽 AZT + 3TC + DTG 🔽 AZT + 3TC + EFV 🔽 AZT + 3TC + LPV/r 🔽 AZT + 3TC + NVP 🔽 AZT + 3TC + RAL 🔽 d4T + 3TC + EFV 🔽 d4T + 3TC + LPV/r 🔽 d4T + 3TC + NVP 🔽 ETV + 3TC + DRV + RTV 🔽 RAL + 3TC + DRV + RTV 🔽 RAL + 3TC + DRV + RTV + ABC 🔽 RAL + 3TC + DRV + RTV + AZT 🔽 RAL + 3TC + DRV + RTV + TDF 🔽 TAF + 3TC + DRV/r 🔽 TAF + 3TC + DTG 🔽 TAF + 3TC + LPV/r 🔽 TDF + 3TC + DTG + DRV + RTV 🔽 TDF + 3TC + DTG + ETR + DRV + RTV 🔽 TDF + 3TC + EFV 🔽 TDF + 3TC + LPV/r 🔽 TDF + 3TC + NVP 🔽 TDF + FTC + DTG 🔽 TDF + FTC + EFV | dfbe256e-30ba-4033-837a-2e8477f2e7cd 164432 ARV regimen/code for drugs collected | |
Stop ART - Refused treatment | ||
Date patient refused HIV care/treatment ␣␣-␣␣-␣␣␣␣ 📆 | ||
Reason for discontinuing service (text) __________________________________ | ||
Restart ART | ||
Date restarted ART ␣␣-␣␣-␣␣␣␣ 📆 | ||
Regimen line 🔽 Adult 1st line ARV regimen 🔽 Adult 2nd line ARV regimen 🔽 Child 1st line ARV regimen 🔽 Child 2nd line ARV regimen | Regimen *** | |
Regimen 🔽 ABC + 3TC + ATVr 🔽 ABC + 3TC + DRV+RTV+RAL 🔽 ABC + 3TC + DRVr 🔽 ABC + 3TC + DTG 🔽 ABC + 3TC + EFV 🔽 ABC + 3TC + LPV/r 🔽 ABC + 3TC + NVP 🔽 ABC + 3TC + RAL 🔽 AZT + 3TC + ATV/r 🔽 AZT + 3TC + DRV + RTV + RAL 🔽 AZT + 3TC + DTG 🔽 AZT + 3TC + EFV 🔽 AZT + 3TC + LPV/r 🔽 AZT + 3TC + NVP 🔽 AZT + 3TC + RAL 🔽 d4T + 3TC + EFV 🔽 d4T + 3TC + LPV/r 🔽 d4T + 3TC + NVP 🔽 ETV + 3TC + DRV + RTV 🔽 RAL + 3TC + DRV + RTV 🔽 RAL + 3TC + DRV + RTV + ABC 🔽 RAL + 3TC + DRV + RTV + AZT 🔽 RAL + 3TC + DRV + RTV + TDF 🔽 TAF + 3TC + DRV/r 🔽 TAF + 3TC + DTG 🔽 TAF + 3TC + LPV/r 🔽 TDF + 3TC + DTG + DRV + RTV 🔽 TDF + 3TC + DTG + ETR + DRV + RTV 🔽 TDF + 3TC + EFV 🔽 TDF + 3TC + LPV/r 🔽 TDF + 3TC + NVP 🔽 TDF + FTC + DTG 🔽 TDF + FTC + EFV |
164432 ARV regimen/code for drugs collected | |
Reason for restarting ART __________________________________ | ||
Notes | ||
Notes __________________________________ | ||
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