WHO changes advice on HIV therapy

Good news on the HIV front. The World Health Organization now advises giving antiretroviral therapy to people with HIV earlier in the infection cycle, which should slow progression of the disease in individuals and also put a brake on its spread. These changes will likely have their biggest impact in poorer countries served by the WHO’s HIV programme. The organisation previously advised starting antiretroviral therapy (ART) only when levels of the CD4 immune cells attacked by HIV dip below 200 per cubic millimetre of blood, which is typically when symptoms appear. But recent studies have shown that people survive for longer if treated earlier, and that they are less likely to pass on the virus, because ART rapidly flushes it from blood. Save the children So on 30 November, the WHO changed its advice. It now recommends treating patients when their counts have dipped below the higher threshold of 350 cells per cubic millimetre – when they may still be free of symptoms. The WHO also changed advice to breastfeeding women with HIV: it now recommends ART for them due to evidence that this helps stop transmission of HIV to the infant. In addition, the WHO now advises that people with HIV who are co-diagnosed with tuberculosis should receive ART regardless of their CD4 counts. Giving ART to more people will initially cost more. However the WHO reckons this will be offset by decreased hospital and treatment costs due to a drop in HIV infections and increased work productivity as treated individuals take fewer sick days. New Scientist