Groundbreaking Guidelines Expand Population on HIV Drugs by Millions, but Who Will Pay?
Thursday, October 1, 2015
The World Health Organization on Wednesday radically revised its guidelines for those who should be on HIV anti-retrovirals, in a push for early treatment and prevention that it hopes will help end the epidemic by its target date of 2030.
The first major change involves those already infected with HIV. Previously, doctors were to wait until a patient's viral load reached a certain severity before offering treatment. But new studies have shown that treating as early as possible can keep patients healthier and reduce transmission rates with minimal side effects.
The WHO now recommends that anyone infected with HIV begin treatment as soon as possible after diagnosis. That expands the number of people who are eligible for antiretroviral drugs from 28 million to 37 million people around the globe.
The second change involves people who are only at risk of becoming infected. This includes sex workers, people who may have partners who have HIV or who are intravenous drug users. The key words in this new guideline are "substantial risk." In the past, WHO recommended antiretroviral drugs to prevent HIV acquisition (termed pre-exposure prophylaxis, or PrEP) be offered to men who have sex with men. As a result, AIDS researchers and clinicians tended to consider this treatment as only of those at "high risk."
- Health Care