Ghana: WHO issues new HIV recommendations

The World Health Organization (WHO) has published a new human immunodeficiency virus (HIV) treatment guidelines recommending that there was the need to offer antiretroviral therapy (ART) earlier than expected. It said recent evidence indicates that earlier ART would help people with HIV to live longer, healthier lives, and substantially reduce the risk of transmitting HIV to others. Glenn Thomas, WHO Communications Officer in Geneva, made the document available to the Ghana News Agency. It said the move could avert an additional 3 million deaths and prevent 3.5 million more new HIV infections between now and 2025. The new recommendations encourage all countries to initiate treatments in adults living with HIV when their cluster of differentiation four (CD4) cell count falls to 500 cells/mm or less when their immune systems were still strong. The previous WHO recommendation, set in 2010, was to offer treatment at 350 CD4 cells/mm or less. It said 90 per cent of all countries have adopted the 2010 recommendations with few, such as Algeria, Argentina and Brazil, already offering treatment at 500 cells/mm3. WHO has based its recommendation on evidence that treating people with HIV earlier, with safe, affordable, and easier-to-manage medicines can both keep them healthy and lowers the amount of virus in the blood, which reduces the risk of passing it to someone else. If countries can integrate these changes within their national HIV policies, and back them up with the necessary resources, they will see significant health benefits at the public health and individual level, the report noted. The new recommendations also include providing antiretroviral therapy - irrespective of their CD4 count - to all children with HIV under 5 years of age, all pregnant and breastfeeding women with HIV, and to all HIV-positive partners where one partner in the relationship is uninfected. The Organization continues to recommend that all people with HIV with active tuberculosis or with hepatitis B disease receive antiretroviral therapy. It said another new recommendation was to offer all adults starting to take ART the same daily single fixed-dose combination pill. It said this combination was easier to take and safer than alternative combinations previously recommended and can be used in adults, pregnant women, adolescents and older children. The Organization is further encouraging countries to enhance the ways they deliver HIV services, for example by linking them more closely with other health services, such as those for tuberculosis, maternal and child health, sexual and reproductive health, and treatment for drug dependence. Between 2011 and 2012, the largest acceleration ever of people enrolled on ART was achieved, with an extra 1.6 million people benefitting from antiretroviral therapy, increasing the total to 9.7 million people. Furthermore, increased coverage of treatment occurred in every region of the world, with Africa leading. Four out of 5 people who started treatment in 2012 were living in sub-Saharan Africa, it stated. It said the recommended treatment is now a combination of three antiretroviral drugs: tenofovir and lamivudine (or emtricitabine) and efavirenz, as a single pill, given once daily.