02 Jul 2013, BioSpectrum Bureau , BioSpectrum
Singapore: The World Health Organization (WHO) is raising treatment initiation guidelines for HIV-positive individuals from a CD4 count (stage of HIV diseas) of less than 350 to a count of less than 500. AIDS Healthcare Foundation (AHF) is supporting the initiative for allowing more HIV-infected people to start treatment earlier.
WHO officials announced the change in conjunction with the International AIDS Society's 7th Conference on HIV Pathogenesis, Treatment and Prevention, held in Kuala Lumpur on July 1. According to WHO officials, earlier treatment initiation will make 26 million people eligible to receive lifesaving antiretroviral medicine, an increase of 76 percrent from the current 14.8 million.
"We applaud WHO for bringing together in the new guidelines all the scientific evidence that's come out in recent years on how to put the HIV epidemic on a downward path. All the evidence clearly points in the same direction - earlier treatment initiation saves lives and prevents new infections," said Dr Jorge Saavedra, global ambassador, AIDS Healthcare Foundation.
"It is my hope that we can now put to rest the debate over whether treatment as prevention works, and focus on what matters most, getting HIV positive people into care and treatment and getting world leaders to commit the necessary resource to achieve Universal Access to treatment. We will continue to stumble short of the global AIDS control so long as Universal Access is not truly universal and only a fraction of all those who need treatment, actually have it," he added
"With the new, earlier treatment initiation guidelines many more people across Africa will be able to regain their strength and lives, instead of languishing in illness until they are finally eligible to start treatment. Mothers will now be able to get up in the morning, see their healthy children off to school, go to work, take care of their families and stay alive," said Dr Penninah Iutung, AHF's Africa bureau chief.
"They will be there the next day and the day after, something that has not been possible only a few years ago. We thank WHO for taking steps to ensure that mothers, infants, children and adolescents have earlier access to treatment and treatment - they are often the most vulnerable to HIV/AIDS and the most overlooked," Dr Iutung added.
"These newly announced WHO guidelines recommend treatment initiation for people co-infected with HIV and active TB regardless of the CD4 cell count. This will be a welcomed changed especially for Eastern Europe, where TB is the leading cause of death among HIV positive people, and alarmingly multi-drug resistant TB is on the rise," said Dr Damir Bikmukhametov, medical director, European Bureau for AIDS Healthcare Foundation in Kazan, Russia.
"There's strong evidence that early treatment initiation vastly improves clinical outcomes in people co-infected with HIV/TB, reducing morbidity and mortality. Our hope is that policy makers will heed WHO's evidence-based recommendations and adopt them - tens of thousands of lives will be saved if this is done," he added.
"Without testing and linkage to care we cannot hope to achieve success in the fight against AIDS, even if there is treatment available. We commend WHO for including a strong emphasis on community-based testing and linkage to care, particularly among high-risk groups in the updated treatment initiation guidelines," said Dr. Chhim Sarath, Asia Bureau Chief, AIDS Healthcare Foundation. "Hundreds of thousands of people still go undiagnosed, not knowing their HIV status and putting their loved ones at risk. If we strengthen the emphasis on prevention and testing, our efforts will go a long way in helping reduce the rate of new infections. Eventually, if more people are put on treatment than become infected, we will be able to turn the tide on AIDS."
"As before, AHF has led the way in advocating for changes to the WHO treatment initiation guidelines - and once again we have taken another important step forward toward curbing AIDS by providing treatment to those who need it, sooner. We salute WHO's historic move to bring the guidelines in line with the overwhelming evidence that earlier treatment initiation saves lives, despite resistance from detractors who are reluctant to face the reality that new political and financial commitments will have to be made in order to provide treatment to more people," said Mr Terri Ford, chief of global policy, AIDS Healthcare Foundation.