International AIDS Conference

International AIDS Conference

Issue: July 2013
July 01, 2013
2 min read
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WHO: Earlier ART could prevent 3 million HIV deaths

Issue: July 2013
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WHO issued new HIV treatment guidelines during the opening day of the 2013 International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention in Kuala Lumpur, Malaysia, that recommend offering antiretroviral therapy earlier.

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

Recent evidence has shown that earlier ART use will help those with HIV live longer, healthier lives and will also reduce the risk of spreading HIV to others. An additional 3 million deaths and 3.5 million new HIV infections can be prevented between now and 2025 with earlier ART use.

Margaret Chan

Margaret Chan

The new recommendations encourage all countries to give treatment to adults living with HIV when their CD4 cell count falls to 500 cells/mm3 or less. The previous recommendation, set in 2010, was to offer treatment when CD4 counts fell to 350 cells/mm3 or less.

The recommendations also include providing ART to all children with HIV aged younger than 5 years, all pregnant and breast-feeding women with HIV, and to all HIV-positive partners in which one partner in the relationship is not infected, regardless of CD4 count. Another recommendation includes offering adults on ART the same daily single fixed-dose combination pill, which is easier to take and safer than alternative combination previously recommended. It can be used in adults, pregnant women, adolescents and older children.

“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,” UNICEF Executive Director Anthony Lake said. “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.”

WHO, UNAIDS and UNICEF also highlighted areas that are still in need of attention. Many key populations, such as people who inject drugs, men who have sex with men, transgender people and sex workers, continue to face legal and cultural barriers preventing them from getting the necessary treatment. The issue of people “dropping out” of treatment also needs to be addressed.

However, the new recommendations would expand the number of people eligible for ART to 26 million.

“Today nearly 10 million people have access to lifesaving treatment,” UNAIDS Executive Director Michel Sidibé said. “This is a true development triumph. But we now have a new challenge — ensuring that all 26 million people eligible for treatment have access — not one person less. Any new HIV infection or AIDS-related death due to a lack of access to antiretroviral therapy is unacceptable.”

Disclosure: The researchers report no relevant financial disclosures.