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HIV drugs should be initiated earlier, says UN

The UN's World Health Organisation (WHO) today issued the first overhaul of its guidelines on HIV drugs in four years, saying the therapy now saving more than five million lives should be initiated at an earlier stage of infection.

world Updated: Jul 19, 2010 14:33 IST

The UN's World Health Organisation (WHO) on Monday issued the first overhaul of its guidelines on HIV drugs in four years, saying the therapy now saving more than five million lives should be initiated at an earlier stage of infection.

A phonebook-sized volume issued at the International AIDS Conference in Vienna confirmed and amplified a key recommendation made by the UN agency last year about earlier use of antiretroviral therapy (ART).

The 156-page report highlighted the leading role played by the famous drug "cocktail" in fighting the human immunodeficiency virus (HIV) which causes AIDS.

The combination therapy, which was first introduced in 1996 but initially restricted to rich countries because of its then high cost, reached 5.2 million people in 2009, an increase of 1.2 million over 2008, the report said.

At least 4.3 million other poor, badly-infected people still need access to the treatment, according to a 2008 count.

In 2006, the WHO advised drug initiation when the tally CD4 cells -- the key immune cells targeted by HIV -- reached 200 cells or less per microlitre of blood, a stage that meant a patient's immune system had already been badly weakened by the virus.

In 2009, citing evidence about the drugs' effectiveness and safety, the agency raised the figure to 350 CD4 cells per microlitre of blood, which thus means at an earlier stage of infection.

This recommendation is spelled out in the new report, along with many other guidelines on drug use, including second-line therapy if a first course of treatment fails.

"All adolescents and adults including pregnant women with HIV infection and CD4 counts of 350 cells/mm3, should start ART, regardless of the presence or absence of clinical symptoms," said the report.