WHO issues new guidelines on the use of antiretroviral medicines

The World Health Organization (WHO) has released new guidelines on the use of antiretroviral medicines. These have been welcomed by UNAIDS as a significant step towards improving the lives of people living with HIV and reducing the transmission of the virus.

The guidelines recommend that antiretroviral medicines be prescribed to people as soon as possible after their HIV diagnosis regardless of their CD4 count (CD4 is a measure of immune system health).The guidelines also recommend that people at higher risk of HIV infection be given access to pre-exposure prophylaxis (PrEP) as part of a combined HIV prevention strategy.

“These new guidelines and recommendations are a highly significant moment in the AIDS response,” said Michel Sidibé, Executive Director of UNAIDS. “The medicines and scientific tools now at our disposal provide us with a real opportunity to save millions of lives over the coming years and to end the AIDS epidemic by 2030.”

The WHO guidelines, produced with the support of UNAIDS, are being released following the increased weight of research evidence that has emerged over the past 12 months. This included data from the international randomized clinical trials Temprano and START (Strategic Timing of Antiretroviral Treatment), which found compelling evidence of the benefits of immediately starting antiretroviral therapy. The data from Temprano and START followed a series of research findings over several years demonstrating the health benefits of starting HIV treatment earlier.

“We welcome the early release of this guideline. The two recommendations are critically important to moving us towards the fast-track treatment and prevention goals. Expanding access to treatment and prevention, especially for key populations and adolescent girls, is now a major global health challenge that requires our collective commitment and determination. We must embrace ambition if we are going to end HIV as a public health threat,” said Mark Dybul, Executive Director, The Global Fund.

Several research studies among groups at higher risk of HIV infection have also indicated the significant efficacy of PrEP in reducing new HIV infections. The new guidelines recommend that PrEP be offered to anybody at substantial risk of HIV exposure.

The guidelines will also help reinforce the UNAIDS Fast-Track approach, which encompasses a set of targets to be reached by 2020. The targets include 90% of all people living with HIV knowing their HIV status, 90% of people who know their HIVpositive status having access to treatment and 90% of people on treatment having suppressed viral loads. They also include reducing new HIV infections by 75% and achieving zero discrimination. “We are at a crossroads in the response to AIDS,” said Mr Sidibé. “We know what works – now we need to put people first and fully respect their right to health.”

UNAIDS reaffirms the importance of respecting a person’s right to know their HIV status and to decide whether and when to begin antiretroviral therapy. HIV prevention and treatment decisions must be well-informed and voluntary. Wider and more equitable delivery of antiretroviral therapy and PrEP will require increased efforts to address the social and legal barriers that inhibit access to health services for people living with HIV and for marginalized populations at higher risk of infection.

Chris Beyrer, President, International AIDS Society, said: “Providing antiretroviral treatment upon diagnosis is the best way to preserve the health of people living with HIV and PrEP ensures prevention equity for all. The WHO adoption of these treatment and prevention measures in their guidelines is a major milestone for the HIV/AIDS response. This sends a signal that I hope will inspire governments, funders, and the international community to act now.”

Guideline on when to start antiretroviral therapy and on pre-exposure prophylaxis for HIV

 Date of upload: 16th Nov 2015


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