| Drug | Class | Adult | Paediatric | Notes |
|---|---|---|---|---|
| Tenofovir + lamivudine + dolutegravir (TLD)[1] | NRTI + NRTI + INSTI fixed-dose combination | Tenofovir 300 mg + lamivudine 300 mg + dolutegravir 50 mg PO once daily | Weight-band dosing per NACO paediatric tables | Preferred first-line for adults and adolescents. Effective in pregnancy (post first-trimester safety reassurance from Tsepamo/PROMISE) |
| Cotrimoxazole (TMP-SMX)[1] | Folate-pathway inhibitor | 960 mg PO once daily as prophylaxis | Weight-band dosing | PCP and toxoplasmosis prophylaxis when CD4 <200 or active TB; continue until CD4 >200 sustained for 3 months |
| Isoniazid preventive therapy (or 3HP / 1HP)[2] | TB preventive therapy | INH 300 mg PO daily × 6 months OR 3HP (rifapentine 900 mg + INH 900 mg weekly × 12) OR 1HP (daily INH+rifapentine × 1 month) | — | All people with HIV; 1HP regimen now NACO-endorsed for shorter completion |
| Atazanavir/ritonavir or lopinavir/ritonavir (second-line)[1] | Protease inhibitor | Atazanavir 300 mg + ritonavir 100 mg PO once daily; lopinavir/ritonavir 400/100 mg BD | — | Second-line if first-line dolutegravir failure with documented resistance |
| Darunavir/ritonavir (third-line)[1] | Protease inhibitor (high-genetic-barrier) | Darunavir 600 mg + ritonavir 100 mg PO BD | — | Third-line; combine with raltegravir or new NRTI backbone per resistance testing |
First-line antiretroviral therapy initiation, monitoring, and switch criteria per NACO national programme, with dolutegravir-based regimens as preferred backbone.