HIV-positive patients will from now on go on antiretroviral treatment as soon as they test positive, unlike in the past where they had to wait for their CD4 count to drop to a certain level, the World Health Organization (WHO) announced last week.
This is one of the two new guidelines that were released at the end of last month by the WHO. The guidelines will form part of the WHO’s revised and updated 2016 guidelines on the use of antiretroviral drugs for treating and preventing HIV infections. The new guidelines are set for release in December.
WHO said 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 alive and healthier, and reduces the risk of transmitting the virus to partners.
Unlike in the past when HIV-positive patients were mainly treated after their CD4 count had dropped to 500 cells/mm3 before going on antiretrovirals, the new guidelines set by the WHO recommend that patients go on treatment as soon as they test positive.
The second change is that pre-exposure prophylaxis (PrEP) against HIV infection should be widely available to HIV negative people who are at substantial risk of infection, in order to reduce their risk of infection.
Currently, PrEP is most widely used as a daily pill that contains two HIV drugs, tenofovir DF and emtricitabine.
“Both recommendations are significant for their impact on global health to reduce HIV-related illnesses and deaths and to reduce new infections,” said WHO.
The global healthy body also stated that the recommendations are controversial in being aspirational goals to drive access to both ART and PrEP, which is still very limited for many people and in many parts of the world.
WHO also recommended that people at “substantial” risk of HIV should be offered preventive antiretroviral treatment.
Based on the new recommendations, the number of people eligible for antiretroviral treatment increased from 28 million to 37 million people who currently live with HIV globally.
Speaking briefly to New Era yesterday, health minister Bernard Haufiku said the new guidelines would mean more resources must be allocated to cater for the new guidelines.
“If those are WHO guidelines then it is what we must follow. The only implication is that we will have more people on treatment, therefore we need more funds,” said the minister. Namibia is one of the African countries enjoying remarkable coverage of life-saving antiretroviral (ARV) treatment, with about 90 percent of Namibians living with HIV and AIDS receiving ARVs from the state.
According to the WHO 2013 global update on HIV treatment, Namibia is ranked among the top African countries in ARV delivery.
About 104 531 HIV-positive Namibians are on ARV treatment.
The prevalence of HIV in Namibia is among the highest in the world. Since 1996, HIV has been the leading cause of death in the country.
Unofficial statistics indicate that close to 17 percent of the country’s children under the age of 18 are orphaned by at least one parent – mostly due to HIV.