AHF on New WHO HIV/AIDS Guidelines: Early Treatment Initiation Will Save Lives

ast Year, AHF-Led Campaign Urged the World Health Organization to Update Guidelines to Recommend Early HIV Treatment Initiation for Expectant Mothers and to Raise the Initiation Threshold from a CD4+ T cell count of <200 cells/mm3 to <350 for All Adults and Adolescents

By: AIDS Healthcare Foundation
Los Angeles, CA - November 30, 2009

On the eve of World AIDS Day 2009, AIDS Healthcare Foundation (AHF) praised the World Health Organization (WHO) for its new HIV treatment recommendations which include starting lifesaving antiretroviral treatment (ART) earlier (at a t-cell count of <350 cells/mm3 instead of <200) for all HIV-positive adults and adolescents and earlier treatment initiation for HIV-positive pregnant women who should now begin treatment at 14 weeks into pregnancy, rather than 28 weeks as previously recommended, and continue until the end of breastfeeding.

AHF has been advocating for such changes for more than a year and spearheaded a campaign Save Mothers’ and Infants’ Lives which generated a letter to WHO General Director, Dr. Margaret Chan urging an end to harmful single-dose HIV/AIDS treatment as a recommended treatment for expectant mothers and infants worldwide. The letter was signed by a coalition of hundreds of HIV/AIDS medical care providers and advocates, representing dozens of organizations, expressing concern over WHO’s outdated recommendation of short-course therapy (such as single-dose Nevirapine and/or Zidovudine) for expectant and breastfeeding mothers. Such therapy—standard practice in many resource-constrained settings—has been proven to be less effective at preventing mother-to-child HIV transmission as well as less safe for both mother and child than full-course Highly Active Antiretroviral Therapy (HAART).

“AHF praises WHO for its leadership in updating its HIV treatment guidelines,” said Michael Weinstein, President of AIDS Healthcare Foundation. “We, along with hundreds of AIDS medical providers and advocates, have been urging these changes for some time now in order to put an end to the harmful use of sub-standard single-dose HIV treatment for expectant mothers and their newborns. Study after study has linked the use of single-dose treatments for expectant mothers to viral resistance, jeopardizing the effectiveness of future treatment and lowering the chances of a patient’s survival. Accepting the status quo and treating expectant mothers and infants in low-income countries with low-quality therapy—especially as the number of people accessing treatment increases—has had dire consequences and it is high time for this practice to end.”

“Those of us working in the field welcome these changes to the WHO guidelines, especially as the previous recommendations encouraged the continuation of single-dose treatment for pregnant women to prevent mother-to-child-transmission—a practice that endangers the lives of mothers and infants,” said Terri Ford, Senior Director of Global Policy/Advocacy for AIDS Healthcare Foundation. “Since most developing countries rely on the guidelines to help shape health policy, WHO’s leadership on this issue will go a long way toward widespread implementation of full-course therapy for all expectant mothers and infants. The lives of thousands of women and children will be saved.”

In addition to advocating for earlier treatment initiation for expectant mothers, AHF also led an effort urging WHO to revise its guidelines and raise the recommended treatment initiation threshold from a CD4+ T cell count of <200 cells/mm3 to <350 for all adults and adolescents living with HIV. The ART Initiation at <350 campaign urged this change in light of scientific evidence correlating earlier treatment with vastly improved health outcomes and lower death rates.

“AHF lauds WHO for these crucial changes recommending earlier treatment initiation,” said Jorge Saavedra, M.D., Chief of Global Affairs for AIDS Healthcare Foundation. “Raising the recommended treatment initiation threshold from a CD4+ T cell count of <200 to <350 has removed one more barrier to accessing lifesaving HIV/AIDS treatment and will have a positive economic impact on resource-constrained countries, ultimately reducing the healthcare costs associated with the treatment of preventable HIV/AIDS-related conditions.

He added: “Most importantly, this change will significantly improve health outcomes, increasing the odds of survival for millions of people living with HIV/AIDS around the world.”