What follow-up care and monitoring should I provide for patients on antiretroviral therapy?

Patients undergoing antiretroviral therapy (ART) require structured follow-up care and monitoring to ensure treatment efficacy, adherence, and early detection of adverse effects. Regular viral load monitoring is essential to assess treatment response and achieve viral suppression, ideally aiming for undetectable HIV RNA levels; this can be facilitated by point-of-care viral load testing to improve timely clinical decisions and adherence support (Meloni et al., 2019). Clinical review visits should include assessment of adherence, side effects, and mental health, with integration of depression management algorithms within the HIV care setting to optimize overall patient outcomes (Adams et al., 2012).

Laboratory monitoring should include full blood count, liver and renal function tests before starting ART and periodically thereafter to detect drug toxicity early, as some antiretrovirals can affect these parameters ¹. Monitoring intervals may be every 3 to 6 months depending on clinical stability and specific drug regimens ¹.

Adherence support and counselling are critical components of follow-up care to maintain viral suppression and prevent resistance; multidisciplinary teams should provide tailored interventions and education (Meloni et al., 2019). Additionally, mental health screening and management should be integrated into routine follow-up to address depression, which is common in people living with HIV and can impact adherence (Adams et al., 2012).

Resistance testing should be considered if viral load rebound occurs to guide regimen changes ¹. Furthermore, monitoring for co-infections and comorbidities, such as hepatitis B and tuberculosis, is important given their prevalence and impact on ART management ¹,².

In summary, follow-up care for patients on ART involves regular viral load and laboratory monitoring, adherence and mental health support, and multidisciplinary management to optimize treatment outcomes and patient well-being ¹[(Adams et al., 2012)][(Meloni et al., 2019)].