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HIV patients to get early treatment

Monday December 21 2015

East African countries will as from next year start implementing the revised World Health Organisation guidelines for HIV treatment.

The new “test and offer to treat” approach will ensure that people living with HIV can benefit from early treatment.

In September, WHO recommended that all people living with HIV start ART as soon as possible after diagnosis.

With its “treat-all” recommendation, WHO removed all limitations on eligibility for antiretroviral therapy (ART) among people living with HIV. All populations and age groups are now eligible for treatment.

According to Magda Robalo, director of communicable diseases at the WHO regional office for Africa, WHO is already working with East African governments to implement the ART guidelines that were launched during the International Conference on AIDS and STIs in Africa (ICASA) in Zimbabwe and the next step will be workshops in the countries in early 2016.

“These workshops will take experts through the details of what it entails in their national contexts and will be followed by country specific technical support missions to help countries adapt the guidelines to their specific context and roll out implementation,” said Dr Robalo.

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To meet the new guidelines, the governments have launched a new digital application called “the situation room” to better co-ordinate response efforts.

Users of the application can tell how many people are infected with HIV/Aids in an area, how many are on medication and what amount of medicine is available in the local health facility.

Kevin De Cock, Kenya country director for the US-based Centres for Disease Control and Prevention (CDC) said the new policies could help avert more than 21 million deaths and 28 million new infections by 2030.

In East Africa, Dr De Cock said, the number of patients on ARVs is likely to go up by between 15 and 20 per cent. This will translate into a decrease in HIV/Aids related deaths and fewer infections in both children and adults.

“As from next year, CDC in partnership with the Kenyan government, will start the pilot programme of identifying those already infected with HIV and putting them on the ARVs treatment immediately,” said Dr De Cock.

The expanded use of antiretroviral treatment is supported by recent findings from clinical trials confirming that early use of ART keeps people living with HIV healthier and reduces the risk of transmitting the virus to partners.

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 is shared ahead of the full publication, slated for release later this year.

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.

The targets include 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.

“Short of an HIV vaccine or cure, this gives us the critical tools we need to create an Aids-free generation with the ‘fasttrack strategy.’ We must seize this moment and chart a bold course together to end the AIDS epidemic as a public health threat,” said Deborah Birx, US global Aids co-ordinator

WHO also recommends that people at “substantial” risk of HIV should be offered preventive antiretroviral treatment. This recommendation builds on 2014 WHO guidance to offer a combination of antiretroviral drugs to prevent HIV acquisition and pre-exposure prophylaxis, for men who have sex with men.

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