23/06/2026
QUERY OF THE WEEK:
A nurse from Gauteng called, asking about her patient, a 26-year old man who started TLD 10 months ago. His 3-month (3DC) VL was < 50 c/mL and he was seen at month 4 (4DCs) where his 3-month VL was discussed.
At that visit, he chose to join a RPCs so he could collect is ART at the Clicks close to his work, which he did , at M7/7DCs. He is back today and has had bloods drawn for his 10-month (10 DCs) VL. He is clinically well.
The nurse is unsure about when she should ask the client to return and rescript?
ANSWER:
As per the 2026 NDOH HIV Guidelines, for VLs subsequent to the 3-month (3 DCs) one, clinically well clients should not be required to come back to the facility the following month for VL result review prior to rescript. Clients should be rescripted at the same visit that their VL is taken.
This, clinically well, client should return only when his next clinical review is needed in 6 months' time (M16; 16 DCs). He will collect his second batch of 3-months of ART at M13/13DCs, from Clicks. He should be counselled that, should he feel unwell, he should return immediately.
IMPORTANTLY, facilities should ensure that results management processes are in place to ensure that results are reviewed by a clinician, and any client with an elevated VL or other abnormal result is recalled to the clinic immediately.
The visit schedule on Page 42 of the 2026 NDOH HIV Guidelines (see image) is very useful.
We welcome calls from all HCWs. No question is too simple (or too complicated): we're happy to help with them all, and the more complicated ones, we discuss with experienced HIV consultants!
If you need help with your HIV- and/or TB-infected patients, feel free to phone us on the toll-free Hotline - 0800 212 506 - and we'll gladly help you.