New guidelines on ARVs

Jul 30, 2010

At the recently concluded AIDS International Conference in Vienna, Austria, one of the new developments was the new World Health Organisation (WHO) guidelines for people living with HIV to start medication (ARVs).

By Anne Abaho

At the recently concluded AIDS International Conference in Vienna, Austria, one of the new developments was the new World Health Organisation (WHO) guidelines for people living with HIV to start medication (ARVs).

The WHO guidelines are mainly for resource limited settings where people have to wait for government to offer them free ARVs. Key changes include a recommendation that treatment should be started earlier – at a CD4 cell count of 350 rather than 200.

Starting treatment at higher CD4 cell counts has been shown to reduce the risk of HIV-related illnesses and other serious illnesses as well, such as cardiovascular disease.

WHO estimates that this will increase the number of patients eligible for treatment from 10 million to 15 million.

All HIV-positive patients with tuberculosis (TB) are now recommended to start antiretroviral therapy regardless of their CD4 cell count.

There’s also an acknowledgement in the revised guidelines that increasing the coverage of treatment has public health benefits and could help slow the pace of the epidemic.

There’s growing consensus that taking HIV treatment significantly lowers the risk of transmission of the virus.

According to a study done in South Africa, HIV-positive adolescents, who start ARVs before their CD4 cell count falls below 200, have significantly better growth than those who initiate treatment when their immune system is weaker.

Conducted in Soweto, the research involved 107 adolescents who had been taking anti-HIV drugs for an average of six years.

Those who started therapy before their CD4 cell count fell to below 200 had significantly better height-for-age scores than those commencing treatment later.

Dr. Kevin Moody of the Global Network of People Living with HIV/AIDS (GNP+) welcomed the new guidelines, saying: “We think it will help to improve people’s quality of life and people will have better health outcomes.”

“We are also interested in the fact that earlier treatment may have prevention benefits,” he added. According to WHO, five million people are now taking anti-retroviral drugs.

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