WHO: Earlier care for HIV patients

Technology.am (Nov. 30, 2009) — Patients infected with the virus that causing AIDS must begin treatment in advance than at present suggested, the World Health Organization said Monday.

whoThe U.N. agency issued fresh regulation advising doctors to begin giving patients AIDS drugs a year or two in advance than customary. The guidance could double the number of people worldwide who become certified for treatment, adding up an extra 3 to 5 million patients to the 5 million already in anticipation of AIDS drugs.

WHO’s earlier HIV treatment recommendation was published in 2006. Since then, some studies have shown people with HIV who begin drugs earlier than suggested have an enhanced possibility of existing.

WHO now advises doctors to begin HIV patients on drugs when their level of CD4 cells – a gauge of the immune system – is about 350. Before they said doctors must wait until patients’ levels hovered about 200. In majority of the Western countries, doctors started treating HIV patients when their CD4 count is about 500.

David Ross, an AIDS expert at the London School of Hygiene and Tropical Medicine, said there is convincing proof of HIV patients should begin treatment sooner. People with HIV who aren’t on AIDS drugs are more expected to catch a potentially deadly disease like tuberculosis or grow other complications when they do begin the drugs, Ross said.

WHO’s fresh recommendations too counsel pregnant women with HIV to take the drugs in advance and whilst breast-feeding. The agency too said countries should stage out the utilization of the frequently used AIDS drug stavudine because of its toxic side effects. If countries with huge outbreaks approve the guidance, many more people could survive longer, healthier lives, said Hiroki Nakatani, a top WHO official in a statement.

Still, WHO’s advice raises questions about how countries and donor agencies will compensate for the lifetime AIDS treatment. About 4 million people worldwide are receiving AIDS drugs, but an additional 5 million are still waiting in line. With its latest recommendations, WHO guessed that another 3 to 5 million people currently qualify for the drugs.

It might too be complicated to encourage HIV patients to begin the drugs earlier, when some may not have any AIDS symptoms. Putting more patients on the cure for a longer period of time can also support drug resistance.

Ross said many AIDS programs in Africa are by now struggling. He added there were anecdotal reports of clinics turning away new patients eligible for treatment because they didn’t have enough drugs to treat them.

Some experts believed the latest WHO guidance could include billions to the expenditure of worldwide AIDS programs. “WHO may be biting off more than they can chew,” said Philip Stevens, a director at International Policy Network, a London-based think tank. “I’m not sure how this will be possible to achieve, other than by cutting lots of corners,” he said.

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