New Progress and Guidance on HIV Treatment
Update on People Receiving HIV Treatment
The number of people receiving lifesaving antiretroviral treatment (ART) reached 5.2 million at the end of 2009, up from 4 million in 2008. The addition of 1.2 million people starting on HIV treatment during 2009 was the biggest increase ever seen in a single year. Between 2003-2010, the number of people receiving HIV treatment increased twelve-fold resulting in millions of lives saved.
2010 Guidelines: "Antiretroviral Treatment for HIV Infection in Adults and Adolescents"
The Guidelines present significant evidence and experience on when to initiate ART and what drug regimens to use have accumulated since the 2006 revision of the guidelines. WHO is now launching new guidance on ART for adults and adolescents. The 2010 guidelines recommend:
Eligibility for Treatment
Role of Laboratory Testing
Benefits and Challenges
The new guidelines are based on a solid body of evidence indicating that rates of death, morbidity and HIV and TB transmission are all reduced by starting treatment earlier.
An earlier start to treatment reduces a person's viral load much earlier in the course of their HIV infection, and thereby reduces the risk of onward HIV transmission and could potentially avert a significant number of new HIV infections.
By choosing a limited number of treatment regimens that suit the majority of people in need of ART, as recommended by the new guidelines, governments can achieve economies of scale through the purchase of larger quantities of a smaller number of drugs.
The new guidelines will increase the number of people eligible for HIV treatment from 10 to 15 million. However, the additional costs associated with earlier treatment will very likely be offset by decreased hospital and death costs, increased productivity due to fewer days sick, fewer children orphaned by AIDS, and a drop in new HIV infections.
The main challenge is to increase access to treatment in low- and middle-income countries and to encourage people to receive voluntary HIV testing and counselling before they have any symptoms.
Currently, many HIV positive people are waiting too long before they seek treatment, usually when their CD4 threshold falls below 200 cells/mm3.
Broadening the criteria for treatment may result in some persons in urgent need of treatment being displaced by persons for whom treatment would be beneficial but not as urgent.
In recommending a higher CD4 count threshold for initiation, a guiding principle is that those most in need of treatment should retain priority access.
This article was provided by World Health Organization. Visit WHO's website to find out more about their activities and publications.
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