SA adopts WHO s test and treat HIV guidelines

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1 Page 1 of 5 HOME ABOUT MEDICALBRIEF NEWS ARCHIVES CONTACT US SA adopts WHO s test and treat HIV guidelines PUBLISHED: 11 MAY 2016 South Africa will adopt the World Health Organisation s new test and treat guidelines for HIV patients in September, enabling people to start treatment as soon as they are diagnosed instead of having to wait until their immune systems weaken, Health Minister Aaron Motsoaledi has announced. Business Day reports that current guidelines say patients should wait until their CD4 count, which measures the strength of the immune system, falls below 500 cells per mm³ and that pregnant HIV-positive women should start lifelong treatment. The report says the government also plans to start providing sex workers with preventative treatment, known as preexposure prophylaxis, in June, said the minister. While at first sight the WHO s guidelines might suggest that the country is destined to double the number of patients taking antiretrovirals, government officials and independent experts have previously been quoted as saying that a massive surge in demand is unlikely. Previous policy changes have not triggered large spikes in the numbers of those receiving treatment, and the numbers on treatment are expected to continue to rise steadily. These new programmes will cost an additional R1bn in this year s budget, and we are happy the Treasury has made this amount available, despite the harsh economic environment in which we find ourselves, Motsoaledi is quoted in the report as saying. South Africa has the world s biggest HIV epidemic, and the world s biggest treatment programme. Motsoaledi said Aids deaths in SA had declined from 320,000 a year in 2010 to 140,000 a year in 2014, thanks to the government s drive to expand its treatment programme. The DA s shadow minister for health Wilmot James paid tribute to the minister s commitment to tackling the HIV/Aids epidemic, saying we all applaud you. Professor Salim Karim director of Aids research centre Caprisa said the minister s announcement is undoubtedly a step in the right direction. The Times reports he continued: This policy change has been expected and follows hard on the heels of the December World Health Organisation guidelines on antiretroviral treatment. The impetus for this policy change emanates from compelling new evidence from the START trial presented at the Vancouver Aids conference last year.

2 Page 2 of 5 A 2011 trial conducted in 35 countries called the Strategic Timing Anti Retroviral Treatment (START) study had HIV positive participants half who started HIV treatment as soon as they were diagnosed. The other group waited until their CD4 count dropped below 350. The report says the group that started treatment later had double the incidence of TB non Hodgkins Lymphoma Karposi Sarcoma (a skin cancer) and non-hiv related disease such as heart attacks and certain cancers 86 versus 41 in the group who had treatment immediately. The evidence that starting treatment early was so compelling that the trial was stopped early as it became unethical to delay treatment to those not receiving it. We now have clear-cut proof that it is of significantly greater health benefit to an HIV-infected person to start antiretroviral therapy sooner rather than later said Anthony S Fauci director of the US National Institute of Allergy and Infectious Disease at the time. He added: Moreover early therapy conveys a double benefit not only improving the health of individuals but at the same time by lowering their viral load reducing the risk they will transmit HIV to others. These findings have global implications for the treatment of HIV. Full Business Day report Full report in The Times SHARE THIS ON: Facebook 2 Twitter Sign up for our weekly e-newsletter, delivered every Thursday. Address GO Sign up for our weekly e-newsletter, delivered every Thursday. Address GO Search this website THIS WEEK S MEDICALBRIEF SA adopts WHO s test and treat HIV guidelines

3 Page 3 of 5 DoH s view of SA s radiology industry spectacularly wrong Scores of Gauteng health professionals assaulted SA won t tolerate exclusionary healthcare Motsoaledi SA wants Roche to reduce breast cancer drug price Tolerance of incompetence is key to SA s poor healthcare HST report Protector s investigation of KZN Health tender welcomed SA s immunisation programme in trouble Drug vastly more powerful than morphine hits US market HIV positive women face forced sterilisation Thai medical students cheat using spy technology MSF report on pharmaceutical research priorities First in vitro embryo development beyond implantation stage The effect of lifetime body shape on mortality Sweetened drinks during pregnancy increase infant BMI Benefits and harms of intranasal steroids reviewed Some personal products linked to adverse effects in newborns Ovary removal increases cancer risk Good antiviral response equalises survival rates Treatment as prevention could eliminate HIV/Aids Age-related problems dog older HIV-positive patients Persistently critically ill patients are different and costly Corticosteroid use in TB meningitis patients

4 Page 4 of 5 Low birthweight linked to higher death rates Birth defect risk with Zofran examined SA maternal deaths from caesarean bleeding a national emergency Combination prostate cancer Tx halves death risk Radiotherapy during surgery a cost-effective option Swaddling increases SIDS risk international research review Impact of maternal smoking and weight on social divide Xiao procedure found to be entirely ineffective Long-term use no guarantee of herbal safety E-cigarettes not a satisfying alternative for smokers Testosterone replacement doesn t increase cancer risk Heat training matches altitude training for athletes Physical activity benefits outweigh pollution harm Surgery mortality threeefold higher in poorer countries

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