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WHO expands antiretroviral guidelines

September 30, 2015

The World Health Organization wants all HIV patients to be given antiretroviral drugs immediately after diagnosis. That means that 37 million people worldwide should be on treatment.

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Antiretroviral: HIV AIDS
Image: DW/E.Silvestre

Anyone diagnosed with HIV should receive antiretroviral treatment, the World Health Organization announced, removing limitations on eligibility for antiretroviral therapy (ART). Previous guidelines had suggested ART for patients whose immune cell counts had fallen below a certain threshold.

"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 WHO announced. "Based on the new recommendation, the number of people eligible for antiretroviral treatment increases from 28 million at the present time to all 37 million people who currently live with HIV globally."

Expanding access to treatment is a key aspect to a set of international goals aimed at ending the AIDS epidemic by 2030. These targets include 90 percent of people living with HIV being aware of their HIV infection, 90 percent of those receiving antiretroviral treatment and 90 percent of people on ART having no detectable virus in their blood.

According to the agency, all people at substantial risk of contracting HIV should now receive preventive ART - not just men who have certain types of sex with other men, as WHO called for in 2014. The agency reported that recent findings from clinical trials have confirmed that early use of ART keeps people living with HIV healthier and also reduces their risk of transmitting the virus.

'Dramatically increased support'

WHO shared the guidelines ahead of its next report, slated for release this year, because of the potential public health impact. The agency called for caregivers to employ preventive ART alongside HIV testing, counseling and support, and access to condoms and safe injection equipment.

Doctors Without Borders warned that "turning this new recommendation into reality would require dramatically increased support from donors and governments."

ART suppliers include Gilead, ViiV Healthcare - majority-owned by GlaxoSmithKline - and multiple Indian generic manufacturers. The increased availability of off-brand medication has contributed to a dramatic drop in prices after a several-year period in which treatment was financially out of reach for many infected with HIV and AIDS, exacerbating the outbreak and prolonging individual suffering. Last week, Turing announced that it would drop the price of its Daraprim, a drug used to fight parasites in AIDS and cancer patients, after increasing it from $13 (11.50 euros) to $750 - per pill.

Last year, only about 15 million HIV patients out of more than 37 million infected received treatment, and some public health officials worry that too much attention has been diverted from the virus. AIDS has killed about 40 million people over three decades. Even as the infection rate drops globally, some countries, China among them, have seen upticks in the number of transmissions.

mkg/sms (Reuters, AP)