WHO urges antiretrovirals for all living with HIV
GENEVA, September 30, 2015
Anyone infected with human immunodeficiency virus (HIV) should begin antiretroviral treatment after diagnosis as soon as possible, according to the World Health Organization.
With its 'treat-all' recommendation, WHO seeks to removes all limitations on eligibility for antiretroviral therapy (ART) among people living with HIV, with all populations and age groups now eligible for treatment.
The expanded use of antiretroviral treatment has been supported by recent findings from clinical trials confirming that early use of ART will keep people living with HIV alive, healthier and reduces the risk of transmitting the virus to partners.
WHO has also recommended that people at 'substantial' risk of HIV should be offered preventive antiretroviral treatment. This new recommendation builds on 2014 WHO guidance to offer a combination of antiretroviral drugs to prevent HIV acquisition (termed pre-exposure prophylaxis-PrEP) for men who have sex with men.
Following further evidence of the effectiveness and acceptability of PrEP, WHO has now broadened this recommendation to support the offer of PrEP to other population groups at significant HIV risk.
PrEP should be seen as an additional prevention choice based on a comprehensive package of services, including HIV testing, counselling and support, and access to condoms and safe injection equipment.
The new recommendations on early use of ART and expanded offer of PrEP are contained in WHO’s "Guideline on when to start antiretroviral therapy and on pre-exposure prophylaxis for HIV.”
The new guideline stresses that, in order to effectively implement the recommendations, countries will need to ensure that testing and treatment for HIV infection are readily available and that those undergoing treatment are supported to adhere to recommended regimens and are retained in care.
The recommendations were developed as part of a comprehensive update of the "WHO consolidated guidelines on the use of antiretroviral drugs for preventing and treating HIV infection."
This early release guideline was shared ahead of the full publication, slated for release later this year, because of their potential for public health impact.
Based on the new recommendations, the number of people eligible for antiretroviral treatment increases from 28 million to all 37 million people who currently live with HIV globally. Expanding access to treatment is at the heart of a new set of targets for 2020 with the aim to end the AIDS epidemic by 2030.
These targets included 90 per cent of people living with HIV being aware of their HIV infection, 90 per cent of those receiving antiretroviral treatment, and 90 per cent of people on ART having no detectable virus in their blood.
According to UNAIDS estimates, expanding ART to all people living with HIV and expanding prevention choices can help avert 21 million AIDS-related deaths and 28 million new infections by 2030, it added.
Michel Sidibé, executive director, UNAIDS, said: “Everybody living with HIV has the right to life-saving treatment. The new guidelines are a very important step towards ensuring that all people living with HIV have immediate access to antiretroviral treatment."
Gottfried Hirnschall, director of Department of HIV/AIDS, WHO, said: “These new recommendations will have tremendous impact on peoples’ lives, if rapidly implemented. So we must work together to support countries to translate them into action and results.” - TradeArabia News Service