Anyone who has HIV should begin antiretroviral treatment as soon after diagnosis as possible, officials with WHO announced.
The new guideline – released ahead of full publication later this year – notes that, in order to effectively implement the recommendations, countries will need to ensure that testing and treatment for HIV infection are readily available.
With the “treat-all” recommendation, WHO officials said in a statement that they are seeking to remove all limitations on eligibility for antiretroviral therapy (ART) among people living with HIV. The guidelines also recommend that people at “substantial” risk of HIV be offered preventive ART.
The expanded use of antiretroviral treatment is supported by recent findings from clinical trials confirming that early use of ART keeps people living with HIV alive, healthier and reduces the risk of transmitting the virus to partners.
In reaction to the WHO guideline release, officials with the Centers for Disease Control and Prevention said they “welcomed” the WHO statement, adding that the WHO guidelines align: “with two key U.S. recommendations. In 2012, the U.S. Department of Health and Human Services (HHS) issued treatment guidelines recommending ART for all patients diagnosed with HIV infection. In 2015, this was upgraded to an A1 recommendation, based on the highest quality evidence (a randomized controlled clinical trial) In 2014, CDC issued first-ever clinical guidance recommending physicians consider advising the use of PrEP for gay and bisexual men, heterosexuals, and injection drug users at substantial risk for HIV infection.”
Based on the new recommendations, the number of people eligible for ART increases from 28 million to all 37 million people who currently live with HIV globally, according to WHO estimates.
Expanding access to treatment is at the heart of a new set of targets for 2020. These targets include 90% of people living with HIV being aware of their HIV infection, 90% of those receiving antiretroviral treatment, and 90% of people on ART having no detectable virus in their blood.
According to UNAIDS estimates, expanding ART to all people living with HIV and expanding prevention choices can help avert 21 million AIDS-related deaths and 28 million new infections by 2030.