WHO Advises Early Antiretroviral Drug Treatment for HIV

It seems that everyday, research in medicine, disease and treatments fluctuates based on new technologies and studies. Billions of dollars are being pumped into research that goes towards initiatives such as these so it is no wonder guidance on treatments gets updated on a weekly, or even daily, basis. One such change was recently issued by the World Health Organization (WHO) in reference to treatments for HIV. Their new recommendation is that those people who are infected with HIV should begin their HIV treatments even earlier than they previously recommended; in fact, it could be up to two years earlier. In doing so, the number of patients who would be qualified to receive such treatments could go up 100%. This would increase the pool of those 5 million people who are already on the wait list to begin receiving HIV treatments by an additional 3 to 5 million putting an additional strain on an already strained industry.

The WHO had published their previous guidance three years earlier in 2006; however, over the span of those three years, many studies have been conducted across the globe that strongly suggest that those patients who begin their antiretroviral drug treatments earlier have a higher chance of surviving the disease. The measurement revolves around the level of CD4 cells (an indicator that measure the state of the immune system) in a patient. In the previous guidance, the WHO recommended that drug treatments should begin when the levels dropped to the 200 range. The new guidance is for drug treatmens to begin when the levels are at 350. Western countries, however, usually begin drug treatments when the levels are around 500.

Experts like David Ross from the London School of Hygiene and Tropical Medicine feel there is strong evidence that treatment for HIV should come earlier than previous suggested. He feels that those who are afflicted with HIV and who are not taking the antiretroviral drug treatments are more susceptible to catch diseases that could prove fatal, like tuberculosis. The WHO also advises that pregnant or breast-feeding women who have HIV should also take the drug treatments earlier. In addition to this guidance, the WHO is advocating that the formerly used drug stavudine should no longer be administered as it has potentially lethal side effects. Hiroki Nakatani, an official within WHO, strongly feels that if countries follow these recommendations, those afflicted with HIV could live healthier and lengthier lives.

One looming issue with this new guidance concerns poorer countries and their ability to finance these types of treatments. Currently 4 million people are on the HIV antiretroviral drug treatments with 5 million people on a waiting list to begin treatments. With this newly issued guidance, up to 5 million more people would be qualified to begin their treatments as well. Another concern is being able to convince those patients who have not displayed any symptoms to begin treatments. In addition, some critics feel that by putting patients on treatments for an extended amount of time, a drug resistance could develop. Philip Stevens, a director at International Policy Network, states, “WHO may be biting off more than they can chew. I’m not sure how this will be possible to achieve, other than by cutting lots of corners.”