MINISTRY OF HEALTH OFFICE OF THE DIRECTOR GENERAL Telephone:(020) 2717077 AFYA HOUSE Fax: (020) 2713234 CATHEDRAL ROAD Email: dghealth2019@qgmail.com P. O. Box 30016 — 00100 When replying please quote NAIROBI REF: MOH/ NASCOP/C8T/VOL. 1/4 31 January 2022 All County Directors of Health Thro’ The Chief Executive Officer Council of Governors Delta Plaza NAIROBI RE: GUIDANCE ON CLINICAL OPTIONS FOR CHILDREN ON AZT/3TC 60/30MG ART FORMULATION _ i The Ministry of Health NASCOP in line with the Guidelines on Use of Antiretroviral Drugs for Treating and Preventing HIV in Kenya, 2018 edition and subsequent updated guidance has continued to ensure the availability and transition of Children and Adolescents Living with HIV to optimized ART regimens. Zidovudine/lamivudine (AZT/3TC) 60/30 mg formulation is used among children weighting below 25kg as part of their first line, second-line and third-line regimens. In addition, clients with hypersensitive to Abacavir also use the formulation. Currently, all the in-country stocks of the product expire on 31* of January 2022. To ensure antiretroviral treatment continuity among children in these categories, the Ministry of Health provides the following guidance as an interim guidance: a) Children on AZT/3TC 60/30 mg formulation for 1st Line ART * Transition to ABC/3TC/DTG in line with the current guidance MOH Circular Guidance dated on 09 Sep 2021. This guidance includes children on this formulation who do not have a valid VL. QZ‘* Hypersensitivity to abacavir should be ruled out before transition. b) Children on AZT/3TC 2nd / 3rd Line ART Weighing 14 - 24.9 kgs Recommended | ] Weight dosage _ARV to use 14 -19.9 Kgs 150/75 mg BID _ | AZT/3TC 300/150 mg half (0.5) Tablet BID | ‘AZT/3TC 300/150mg half (0.5) Tablet AM, 20- 24.9 Kgs _| 180/90 mg BID _| one (1) Tablet PM The AZT/3TC 300/150mg adult formulation is available as a scored tablet. Children on 2" line ART regimen weighing below 14Kgs unable to use adult AZT/3TC formulation; Transition to ABC/3TC backbone, conduct Viral Load (VL) within 3 months or as soon as available. Children on 3 Line ART regimen weighing below 14Kgs: Case to case support will be provided through the regional TWGs. ‘All county referral hospitals have been supplied with Dolutegravir 10mg to support the implementation of the interim guidance All the expired products should be quarantined from all service delivery points. No client should be dispensed for the expired product. This is an interim guidance to ensure continuity of care. For any additional clarification about this guidance, kindly reach out to Dr. Rose Wafula head@nascop.or.ke or call the Clinical Support centre through telephone number 0726 460 000. Thank you for your continued support. a Patrick Amoth HEALTH Encls. Copy to: County Chief Officers of Health (COH) All CASCOs All County Pharmacists All Medical Superintendents and facility in charges