Contents to be performed with HIV-infected people for the first time, re-examination in Vietnam

Contents to be performed with HIV-infected people for the first time, re-examination in Vietnam (Internet image)

Regarding this issue, LawNet responded as follows:

1. Contents to be performed with HIV-infected people for the first time examination

Contents to be performed with HIV-infected people for the first time examination according to Article 5 of Circular 28/2018/TT-BYT are as follows:

- Check and compare the patient's personal information on the test result sheet confirming HIV infection with the information on the patient's identification paper.

For children under 18 months of age, compare the personal information on the HIV positive test result sheet by molecular biology with the information on the child's birth certificate.

- Medical examination, assessment of clinical and immunological status, treatment consultation, and management as prescribed in the Guidelines for HIV/AIDS treatment and care after checking and comparing the patient's personal information.

- Prepare for treatment with anti-HIV drugs according to the content specified in the Guidelines for HIV/AIDS treatment and care. Treat people with antiretroviral drugs as soon as people with HIV are ready for treatment.

- Prescribe anti-HIV drugs as prescribed in Clause 2, Article 3 of Circular 28/2018/TT-BYT

- Provide anti-HIV drugs as prescribed in Clauses 3, 4, 5 and 6, Article 4 of Circular 28/2018/TT-BYT with a maximum use quantity of 30 days.

- Make an appointment for a follow-up visit at an antiretroviral treatment facility (hereinafter referred to as a treatment facility) after 2–4 weeks or when there are unusual problems. Record the appointment for re-examination in the Outpatient Medical Record and the Medical Examination book, or Medical Record Book (hereinafter referred to as the medical Examination Book).

- Complete the outpatient medical record according to the instructions in Appendix 01 issued with Circular 28/2018/TT-BYT. Save the original or a legal copy of the confirmation of HIV infection or the positive HIV test by molecular biology technique for children under 18 months old in the medical record.

2. Contents to be performed with HIV-infected people for re-examination in Vietnam

According to Article 6 of Circular 28/2018/TT-BYT, the implementation of HIV-infected people with re-examination as follows:

- Medical examination, monitoring of clinical, immunological, and virological responses, adherence to treatment, diagnosis of comorbidities, and treatment as prescribed in the Guidelines for HIV/AIDS treatment and care.

- Prescribing and dispensing anti-HIV drugs:

+ In cases where the patient has been on antiretroviral therapy for less than 12 months, it is prescribed and dispensed with a maximum quantity of 30 days. In case a patient wishes to receive antiretroviral drugs at a commune, ward, or township health station (hereinafter referred to as a commune health station), then:

Evaluation of criteria for receiving drugs at commune health stations, prescribing and dispensing drugs, and instructing HIV-infected people to receive drugs at commune health stations according to the provisions of Points c, d, Clause 2, Article 6 of Circular 28/2018/TT-BYT.

Write a referral letter according to the instructions in Appendix 02 issued withCircular 28/2018/TT-BYT. Make an appointment for re-examination according to the provisions of Clause 3, Article 6 of Circular 28/2018/TT-BYT;

+ In case the patient has been on antiretroviral therapy for 12 months or more:

In case of unstable antiretroviral drug treatment: prescribe and provide antiretroviral drugs with a maximum quantity of 30 days.

In case antiretroviral therapy is stable and there is a need to continue receiving antiretroviral drugs at the treatment facility: prescribe and provide antiretroviral drugs in a maximum quantity of 90 days.

In case the patient is stable on antiretroviral therapy and wants to receive antiretroviral drugs at the commune health station: Prescribe, supply drugs, and guide HIV-infected people on receiving drugs at commune health stations according to the provisions at Points c, d, Clause 2, Article 6 of Circular 28/2018/TT-BYT.

Write a referral letter according to the instructions in Appendix 02 issued with Article 6 of Circular 28/2018/TT-BYT.

+ Criteria for patients receiving anti-HIV drugs at commune health stations: HIV-infected people on antiretroviral therapy for 6 months or more, have good clinical and immunological responses, have good treatment adherence, and have no side effects of the drugs that need to be monitored regularly, have no comorbidities, and want to receive medicine at the commune health station;

+ Prescribing and dispensing drugs to patients receiving anti-HIV drugs at commune health stations: The treatment facility prescribes antiretroviral drugs in the outpatient medical record and the patient's medical examination book, with the quantity not exceeding 90 days. The number of prescription drugs that can be dispensed in a maximum of 3 batches.

The maximum number of drugs per episode is 30 days of use. In the first phase, the patient received medicine at the treatment facility. In the next session, patients receive medicine at the commune health station. When the medicine is exhausted at the commune health station or according to the appointment schedule for re-examination, the patient will be re-examined at the treatment facility for further examination and prescription.

- Schedule for re-examination:

+ In case the patient receives anti-HIV drugs at the treatment facility: Make an appointment for re-examination when the medicine is exhausted or when there are abnormal signs, record the appointment for re-examination in the patient's medical examination book;

+ In case the patient receives anti-HIV drugs at the commune health station: Periodically check back at the treatment facility every 3 months or when there are abnormal signs; Record the appointment for re-examination in the patient's medical examination book.

- In case the patient comes to the examination and receives medicine earlier than the scheduled time, the patient is still entitled to a medical examination and medication; The number of drugs given during this treatment period is accumulated with the number of drugs the patient has not used up to the date of this examination and is sufficient until the next follow-up appointment.

- By the time of the appointment for re-examination, if the patient does not come to the examination: The treatment facility contacts the patient or the patient's family to remind the patient to come for a follow-up examination and receive medicine according to the appointment.

- In case the patient has dropped out of treatment and returns for treatment: Based on the disease status of the HIV-infected person, the treatment facility provides medical examination and treatment for HIV-infected people as prescribed in Article 5 or Article 6 of Circular 28/2018/TT-BYT.

Le Truong Quoc Dat

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