Today, the World Health Organization released new guidelines on when to start antiretroviral therapy (ART) and pre-exposure prophylaxis for HIV. This is a significant step towards improving and saving lives, since the new guidelines stipulate that ART should begin immediately after testing confirms presence of the virus.
Over the past several years, modifications have been made to the WHO HIV treatment guidelines, steadily lowering the threshold for beginning ART. In the past, patients had to wait until they became symptomatic and had CD4+ T-cell counts below 350 cells/mm3 – a simple measure of immune system health.
The most recent update was informed by two recent studies – one by the French National Agency for Research on AIDS and Viral Hepatitis (ANRS) and another by the US National Institutes of Health –both of which had the following objective: to assess whether taking antiretroviral therapy immediately would lead to a lower risk of AIDS or other serious health issues compared to waiting until a patient’s cell count fell to 350 cells/mm3.
“I welcome the early release guidelines from WHO about treating all persons infected with HIV regardless of CD4 cell count or WHO clinical stage and about recommending pre-exposure prophylaxis with antiretroviral therapy for people at substantial risk of HIV infection as part of a combination prevention package," said Dr Anthony D Harries, Senior Advisor and Director of Department of Research at The Union, who served on the Core Group of experts that developed the new guidelines.
"This will have substantial individual benefits for people living with HIV and, if implemented, will help hugely in reducing HIV transmission. The evidence is there to support the recommendations. The tools are there to do the job,” he said.
“What we now must do is ensure we scale up and treat everyone who is HIV infected. Implementing these recommendations brings us one step closer to ending HIV/AIDS by 2030, and, in the high HIV-TB burden countries, this will also facilitate the ending of tuberculosis.”
For more information, please see the new guidelines
Link to NIH study
Link to ANRS study
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