WHO says that HIV treatment, prevention drugs should be expanded to millions

New guidelines are key to putting 'a halt to the epidemic as we know it,' expert says

The World Health Organization (WHO) on Wednesday released updated guidelines that emphasize early treatment and prevention of HIV.

Old guidelines

Under the previous guidelines, WHO only recommended antiretroviral therapy for patients whose immune system had undergone a certain level of damage, out of concerns that the drugs' costs outweighed their benefits before that point.

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In addition, WHO also recommended that preventive antiretroviral treatment (PrEP) be offered to men who have sex with men, people with HIV-infected partners, and prostitutes.

New guidelines

But WHO now recommends that individuals infected with HIV start treatment as soon post-diagnosis as possible. The organization said in a statement that recent studies have shown that using antiretroviral therapy early "keeps people living with HIV alive, healthier, and reduces the risk of transmitting the virus to partners."

WHO estimated that 37 million people worldwide would now benefit from antiretroviral drugs, up from 28 million under the old guidelines. Only 15 million patients were receiving such treatment in 2014, according to the Joint United Nations Program on HIV/AIDS (UNAIDS).

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And in a second guidelines change—"following further evidence of the effectiveness and acceptability of PrEP"—WHO now says that preventive treatment be provided to anyone who face a "substantial risk" of HIV infection. Donald McNeil writes for the New York Times that the new recommendations effectively expand the suggested patient population by millions of women and girls in Africa.

Overall, WHO said that according to UNAIDS estimates, fully enacting the guidelines could prevent up to 21 million AIDS-related deaths and 28 million new infections by 2030.

Reaction

Deborah Birx, head of the President's Emergency Plan for AIDS Relief and U.S. global AIDS coordinator, told the Wall Street Journal that the new guidelines are "the key to the ability to put a halt to the epidemic as we know it."

Matthew Kavanagh, senior policy analyst at the Health Global Access Project, said, "Now the question becomes how quickly will governments take up this recommendation." Others also questioned the extent to which the drugs would be made available, and who would pay for them (Eunjung Cha, "To Your Health," Washington Post, 9/30; McKay, Wall Street Journal, 9/30; McNeil, New York Times, 9/30).


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