WHO: Earlier ART recommended in new guidelines
The World Health Organization (WHO) has issued new treatment guidelines for HIV, which centers around earlier antiretroviral therapy (ART), according to the newly published guidelines.
The new recommendations are presented in WHO’s “Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection”, could avert an additional 3 million deaths and prevent 3.5 million more new HIV infections between now and 2025.
“These guidelines represent another leap ahead in a trend of ever-higher goals and ever-greater achievements,” says 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.”
Some of the updates include:
The guidelines recommend earlier treatment and raise the threshold for starting ARVs from a CD4 of 350 cells/mm3 to 500 cells/mm3 (i.e. starting treatment when the immune system is stronger) because of the evidence that earlier treatment prolongs life and results in fewer transmission from an infected person to an uninfected person.
The guidelines also recommend that all pregnant women start ART at any CD4 count and continue lifelong or until the risk of transmission of HIV to the infant has passed, and that all children under 5 years should start ART as soon as HIV is diagnosed.
The recommended treatment is now a combination of three antiretroviral drugs: tenofovir and lamivudine (or emtricitabine) and efavirenz, as a single pill, given once daily.
“Advances like these allow children and pregnant women to access treatment earlier and more safely, and move us closer to our goal of an AIDS-free generation,” said UNICEF Executive Director, Anthony Lake. “Now, we must accelerate our efforts, investing in innovations that allow us to test new born babies faster and giving them the appropriate treatment so that they enjoy the best possible start in life.”
The WHO states that compared to current standards, the new guidelines can reduce the number of AIDS deaths and new HIV infections by an additional 36%-39% percent (in the year 2025).
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