WHO guidelines advise earlier HIV treatments
Posted: November 30, 2009 at 4:51 a.m.
LONDON — People infected with the virus that causes AIDS should start treatment earlier than currently recommended, the World Health Organization said today.
The U.N. agency issued new guidance advising doctors to start giving patients AIDS drugs a year or two earlier than usual. The advice could double the number of people worldwide who qualify for treatment, adding an extra 3 million to 5 million patients to the 5 million already awaiting AIDS drugs.
The World Health Organization’s previous HIV treatment advice was published in 2006. Since then, several studies have shown people with HIV who start drugs earlier than recommended have a better chance of surviving.
The health organization now advises doctors to start HIV patients on drugs when their level of CD4 cells - a measure of the immune system - is about 350. Previously, the group said doctors should wait until patients’ levels hovered near 200. In most Western countries, doctors start 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 compelling evidence HIV patients should start treatment sooner. People with HIV who aren’t on AIDS drugs are more likely to catch a potentially fatal disease such as tuberculosis or develop other complications when they do start the drugs, Ross said.
If countries with large outbreaks adopt the guidance, many more people could live longer, healthier lives, said Hiroki Nakatani, a top WHO official in a statement.
The World Health Organization’s new recommendations raised questions about how countries and donor agencies will pay for the lifelong AIDS treatment. About 4 million people worldwide are receiving AIDS drugs, and another 5 million are waiting in line. With its new recommendations, WHO guessed that an additional 3 to 5 million people now qualify for the drugs.
Some experts said the new WHO guidance could add billions to the cost of global 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.
Front Section, Pages 5 on 11/30/2009
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