Medical Criteria

Antiretroviral medication will be provided if:

1. CD4 count is or was less than 500;

2. CD4 count is over 500 with a detectable viral load; or

3. The client is pregnant.

4. A statement from medical provider documenting that client has been receiving antiretroviral therapy and funding source must be submitted to the ADAP Coordinator, via fax, (804) 864-8050 for individual consideration.

Opportunistic infection medication will be provided for:

• Pneumocystis Carinii (PCP) prophylaxis - if the client has or had a CD4 count lower than 250 or active thrush.
• Mycobacterim Avium Complex (MAC) prophylaxis - if the client has or had a CD4 count lower than 100; or the client currently has an opportunistic infection.

Prescriptions and documentation of CD4 count, viral load is needed every six months for anti-HIV medications and once a year for opportunistic infection protection medication.

Rifabutin is only available for treatment of MAC if client is unable to tolerate Zithromax.

Itraconazole is available in a liquid suspension of 100 mg.

Questions or comments? Contact HIV/STD/Viral Hepatitis Hotline