Baseline and routine lab investigations

Clinical description

• If CD4 testing is available at the site: do baseline CD4 count for all adults and children 5+ years

before/when staring ART. However, do not delay ART initiation if CD4 machine is down / results are delayed or testing is currently not available. See section 10.3 on page

• Use point-of-care (POC) machines or semi-quantitative rapid CD4 count test kits.
• Do routine urine LAM and serum CrAg for patients with advanced HIV infection (see section 8.1 on

page 22).

• The national program does not require:

o Routine baseline lab investigations before starting ART or routine investigations for ART toxicity.

o Routine scheduled CD4 monitoring of patients on ART is not supported.

• Use targeted investigations if clinically indicated.
• Monitor VL according to the standard schedule (see section 18.10 on page 90).