ALLENTOWN, Pennsylvania — The International AIDS Society Conference was held July 19-22 where the World Health Organization (WHO) announced it will be launching new guidelines for HIV treatment in December 2015.
The new guidelines will advocate for the immediate treatment of anyone confirmed HIV positive. The new guidelines will also strongly recommend antiretroviral treatment for those who have a high-risk of being infected, such as sex workers, a first, according to WHO’s HIV Director Gottfried Hirnschall.
These new guidelines will aid in achieving one of the targets of the Sustainable Development Goals (SDGs), to be launched in September 2015, to eliminate the AIDS epidemic by 2030.
The result of the new guidelines will increase the number of people eligible for treatment from about 28 to 37 million worldwide. Currently, only 15 million receive treatment, an estimated 41 percent of those infected.
The Elizabeth Glaser Pediatric AIDS Foundation believes there should be more specific targeted goals for children. About 32 percent of children have HIV, which means 80 percent may not see their 5th birthday.
The current guidelines dictate antiretroviral treatment to those infected in the most vulnerable groups, such as children, pregnant women, people with co-infections such as tuberculosis and those whose immune systems have already been weakened by HIV. The antiretroviral treatment of HIV consists of a combo of 3 drugs to suppress HIV.
The new guidelines come as a result of recent large studies that clearly indicate, receiving HIV treatment while the immune system is strong improves patient’s health and helps prevent transmission to sexual partners.
One of the studies, START (Strategic Timing of AntiRetroviral Treatment), followed 4,685 HIV-infected patients from 35 countries, and showed early treatment reduces risk of death or serious health problems by 57 percent.
A couple of HIV Prevention Trials Network’s (HPTN) clinical trials have also shown similar results. HPTN 052 began in 2005 and studied 1,763 couples with one HIV-positive person.
One group started treatment immediately, while the other group received the treatment after a drop in the number of white blood cells called CD4 cells, which help protect against infections.
The transmission rate among the early treatment group was 96 percent lower than the other group by 2011. As a result, and for ethical purposes, the treatment was offered to all couples in the trial. In the end, the HIV transmission rate saw a 93 percent decrease.
Another HPTN clinical trial, HPTN 067, looked at the impact of pre-exposure prophylaxis (PrEP). It used single, black women in South Africa at high risk for HIV infection and found that they followed the daily PrEP regimen, especially when they knew the medications were effective at preventing HIV.
This could be potentially significant among high-risk populations such as mother-to-child transmission efforts and sex workers, if they are educated in the effectiveness of the PrEP regimen.
HIV/AIDS policy advisor at medical aid organisation Médecins Sans Frontières, Shannon Lynch believes most countries will be able to implement the new treatment guidelines, given that it’s easier to treat patients once they are diagnosed HIV positive, as opposed to when their CD4 cell count drops.
Proper education and awareness of immediate treatment and the PrEP regimen will be significant, particularly for those at risk.
– Paula Acevedo