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News
June 30, 2013

WHO issues new HIV guidelines calling for earlier treatment

GENEVA, Switzerland (CMC) – The World Health Organization (WHO) has issued new guidelines urging that people infected with the HIV virus that causes AIDS to receive antiretroviral therapy (ART) earlier.

The new recommendations are presented in WHO’s “Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection” released here over the weekend.

The recommendations point to recent evidence that indicates that earlier ART will help people with HIV to “live longer, healthier lives, and substantially reduce the risk of transmitting HIV to others.

“The move could avert an additional 3 million deaths and prevent 3.5 million more new HIV infections between now and 2025,” the guidelines states, adding that data reveal a total of 9.7 million people were taking these lifesaving drugs at the end of 2012.

“These guidelines represent another leap ahead in a trend of ever-higher goals and ever-greater achievements,” said WHO Director General Dr Margaret Chan.

“With nearly 10 million people now on antiretroviral therapy, we see that such prospects, unthinkable just a few years ago, can now fuel the momentum needed to push the HIV epidemic into irreversible decline,” she added. 

The new recommendations encourage all countries, including the Caribbean, to initiate treatment in adults living with HIV when their CD4 cell count falls to 500 cells/mm³ or less, when their immune systems are still strong.

The previous WHO recommendation, set in 2010, was to offer treatment at 350 CD4 cells/mm³ or less.

WHO said 90 per cent of all countries have adopted the 2010 recommendation. It said a few, such as Algeria, Argentina and Brazil, are already offering treatment at 500 cells/mm3.

WHO said it based its recommendation on evidence that treating people with HIV earlier, with safe, affordable, and easier-to-manage medicines, can both keep them healthy and lower the amount of virus in the blood, “which reduces the risk of passing it to someone else.

“If countries can integrate these changes within their national HIV policies, and back them up with the necessary resources, they will see significant health benefits at the public health and individual level,” the report says.

The new recommendations also include providing antiretroviral therapy – irrespective of their CD4 count – to all children with HIV under five years of age, all pregnant and breastfeeding women with HIV, and to all HIV-positive partners where one partner in the relationship is uninfected.

The organization continues to recommend that all people with HIV with active tuberculosis or with hepatitis B disease receive antiretroviral therapy.

Another new recommendation is to offer all adults starting to take ART the same daily single fixed-dose combination pill.

WHO says this combination is easier to take and safer than alternative combinations previously recommended and can be used in adults, pregnant women, adolescents and older children.

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