The guidelines are based on scientific evidence that early initiation of ART can help people with HIV to live longer, healthier lives, and substantially reduce the risk of transmitting HIV to others. "The new recommendations encourage all countries to initiate treatment in adults living with HIV when their specific (CD4) cell count falls to 500 cells per unit or less against the old norm of 350 cells per unit. This is the time the immune system is still strong," said Dr BB Rewari from National AIDS Control Organisation (NACO).
"The new guidelines offer hope but they will be of use to those in need only when the department responsible for its implementation takes it seriously," said Naresh Yadav, President of UP Network of People living with HIV (UPNP+). "Guidelines cannot save the life of a person, medicines can," he added. Naresh also emphasised improving comprehensive and coordinated response to HIV so that the gains of new WHO guidelines can be translated in positive health outcome on the ground. The new recommendations also include providing antiretroviral therapy-irrespective of their CD4 count-to all children with HIV under 5 years of age, all pregnant and breastfeeding women with HIV, and to all HIV-positive couples where one partner is uninfected.
The WHO continues to recommend that all people with HIV with active tuberculosis (TB) or with hepatitis B disease receive anti-retroviral therapy regardless of their CD4 count.
Another new recommendation is to offer all adults starting to take ART the same daily single fixed-dose combination pill. This combination is easier to take and safer than alternative combinations previously recommended and can be used in adults, pregnant women, adolescents and older children.
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