An ongoing dialogue on HIV/AIDS, infectious diseases,
November 30th, 2009
WHO HIV Treatment Guidelines Updated
This just in:
WHO is now recommending that ART be initiated at a higher CD4 threshold of 350 cells/mm3 for all HIV-positive patients, including pregnant women, regardless of symptoms.
Which makes eminent sense, of course. Because if starting HIV therapy might prolong survival in developed countries, why shouldn’t it do the same in the developing world?
In fact, when you consider the higher incidence of TB and invasive bacterial infections in such settings, it could easily be argued — and has been argued — that starting early would net greater survival gains in resource-poor settings than it would here.
Plus, there’s the CIPRAHT001 Study, which proves it.
But there’s more — the new WHO guidelines also urge that countries “phase out” the use of stavudine in favor of less-toxic NRTIs, and that women continue breastfeeding so long as they are also on ART.
Good news all around.
Paul E. Sax, MD
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