This course is for doctors and nurses working in the Western Cape to provide a 2026 update on the changes to the National Consolidated Guidelines for the Prevention and Management of HIV. 

The purpose of this training is to:

  • Update master-trainers and programme managers on the changes to the Consolidated Guidelines including the Differentiated Model of Care (DMOC) - SOPs.
  • Enhance clinical competence amongst the doctors, nurses and clinicians to manage HIV-related complexities, including advanced HIV disease (AHD), severe opportunistic infections, and multi-drug resistance.
  • Provide guidance on transitioning patients to second- and third-line antiretroviral (ARV) treatments.

About the course

  • Course Design: Self-directed online.

  • Duration: It will take 10 hours to complete.

  • Eligibility for this course:
    • Professional nurses
    • Primary Care Nurse Specialists
    • Medical Officers
    • Endorsed trainers

  • Accreditation: This course is accredited for:
    • HPCSA: 10 Clinical CPD points (Level 1)
    • WCDHW Nursing: 3 CPD points in Area of Practice

  • Certification: Participants need at least 70% for the final quiz.

  • Published: August 2026

Course curriculum

The following topics are covered in this course:

1. Introduction and overview of the guideline

  • Introduction and purpose of the training
  • Overview of the guideline
    • Summary of important updates to the consolidated ART guidelines 
    • National updates already implemented in the Western Cape
    • National updates to which the Western Cape is now aligned
    • Western Cape deviations to 2026 NDOH consolidated guidelines
    • Implementation recommendations


2. Advanced HIV disease (AHD) data

  • What is currently available from the NDoH Health Information Centre (HIC)
  • What is available from the Provincial Health Data Centre/SPV reports
  • How available dashboard views can support monitoring of CD4 testing, AHD-related indicators, CrAg screening and baseline CD4 reporting
  • Key considerations around interpretation, data completeness and follow-up use.


3. Advanced HIV disease (AHD) - 9 steps

  • Step 1: Identifying the seriously ill client 
  • Step 2: Identify high-risk clients 
  • Step 3: Assess and treat
  • Step 4: Prevent opportunistic infections
  • Step 5: Provide ART
  • Step 6: Provide other care
  • Step 7: Provide adherence support
  • Step 8: Ensure continuity of care between hospital and clinic
  • Step 9: Provide intensified follow-up


4. Serious opportunistic infections in AHD

  • Severe bacterial infections 
  • TB in AHD
  • Cryptococcal disease 


5. New viral load monitoring and resistance testing algorithm

  • DTG regimen classification
  • The ABCDE assessment
  • Eligibility criteria for a resistance test
  • Drug-level testing as a gatekeeper
  • Western Cape Third Line Committee


6. Facility-based 6MMD

  • Improved/clarified terms to understand
  • 6MMD eligibility criteria
  • Facility-based 6MMD visit schedule
  • How is 6MMD different in facilities and RPCs?


7. ART regimens for children

  • ARV drug dosing chart for children
  • pDTG dispersible scored tablets
  • Paediatric ALD
  • Practical advice on the administration of ARV drugs
  • ART for term neonates
  • ART for preterm neonates
  • Helplines


8. Renal conditions in PLHIV

  • Increased creatinine due to DTG: mechanism and significance
  • Assessment and management of a creatinine rise on DTG
  • Renal tubular dysfunction due to TDF: Fanconi syndrome
  • TDF stopping rules and the HBV flare risk
  • Renal impairment and distinguishing AKI from CKD
  • HIVAN, CKD management and ART dose adjustments
  • Management principles: ART drug dosage adjustments in renal failure


9. Liver considerations in PLHIV

  • When to suspect AT-DILI and the 3 diagnostic criteria
  • DILI classification and 7-step immediate management
  • Other causes: AT-DILI vs TB-IRIS – the critical distinction
  • TB drug re-challenge schedule and key timeframes
  • Alternate TB regimens and dosages


10. Drug interactions in PLHIV

  • Why drug interactions matter and how they work
  • Drug interactions by ARV class
  • DTG-specific interactions: the complete reference table
  • Practical dosing guide: DTG + calcium + iron in pregnancy
  • Common pitfalls and resources


Western Cape Government Department of Health and Wellness
People Development Centre

Acknowledgements:

  • National Department of Health
  • Knowledge Translation Foundation