HIV pa­tients should be­gin treat­ment rapidly: WHO


The World Health Or­ga­ni­za­tion has re­vised its HIV guide­lines to rec­om­mend that any­one who tests pos­i­tive for the virus that causes AIDS should be treated im­me­di­ately.

That guid­ance fits with what is al­ready rec­om­mended in many de­vel­oped na­tions, in­clud­ing the United States.

The U.N. health agency had pre­vi­ously said doc­tors should wait to treat some peo­ple with HIV un­til their im­mune sys­tems sug­gested they were get­ting sick. But in a state­ment Wed­nes­day, WHO said the new rec­om­men­da­tions are based on re­cent tri­als that have found early treat­ment “keeps peo­ple with HIV alive, health­ier and re­duces the risk of trans­mit­ting the virus.”

The new guid­ance means that all 37 mil­lion peo­ple with HIV glob­ally should be of­fered im­me­di­ate treat­ment, a prospect that may be un­re­al­is­tic in poor coun­tries, where many pa­tients are still un- able to get medicines. Last year, only about 15 mil­lion peo­ple with HIV were be­ing treated.

WHO says the sick­est pa­tients should be pri­or­i­tized and that peo­ple who are at high risk of be­ing in­fected should also be of­fered pre­ven­tive ther­apy.

While other ex­perts com­mended the new guide­lines, they warned that ful­fill­ing them would re­quire a sub­stan­tial cash in­jec­tion and an over­haul of cur­rent strate­gies.

“To work as a tool to con­trol the epi­demic, (these guide­lines) will re­quire dras­tic changes and in­creased in­vest­ment,” said Dr. Tom Ell­man, di­rec­tor of the South­ern Africa Med­i­cal Unit for Doc­tors With­out Borders. “No­body’s go­ing to end AIDS with busi­ness as usual.”

He said HIV treat­ment had to move out of the clin­ics into the com­mu­ni­ties where pa­tients live.

WHO and the U.N. AIDS agency es­ti­mated that im­ple­ment­ing the new guide­lines could avert 21 mil­lion AIDS deaths and pre­vent 28 mil­lion new in­fec­tions by 2030.

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