23 Sep 2009
PLHIV provide recommendations for revision of ART Guidelines
During Summer 2009 GNP+ identified key recommendations for the revision of the World Health Organisation’s Recommendations for Antiretroviral Therapy (ART) for HIV Infection in Adults and Adolescents (ART Guidelines). In two technical consultations at the IAS 2009 Cape Town and ICAAP 2009 Bali conferences, as well as an e-consultation, people living with HIV discussed what they expect from their treatment programmes, what should be included in the coming ART Guidelines revision, and what should not be included.
Consultation participants recommend that the ART Guidelines should be based on the best scientific knowledge, and should recommend that treatment is initiated when CD4 cell counts fall below 350. However, people living with HIV must be able and empowered to make their own individual decisions about when to start and change treatment based on accurate information about treatment options, side-effects, drug resistance and co-infections. WHO guidelines should no longer recommend d4T but recommend tenofovir in its place.
In addition, PLHIV should have access to regular CD4 counts and periodic viral load tests (at least to confirm treatment failure before switching to second line). The role of resistance testing needs to be assessed in resource constrained settings.
People living with HIV participating in the consultations agreed that their lives could be directly impacted by the revised ART Guidelines. However, they also noted that actual clinical practice was rarely up to the standards recommended by the ART Guidelines — including the treatment they themselves received. They highlighted the role of people living with HIV to use the ART guidelines as an advocacy tool, in ensuring that governments and funders see the long-term cost-effectiveness of starting treatment earlier and with better drugs.
Along with ITPC, ICW and Young Positives, GNP+ is continuing to support the ART Guidelines revision process, including the participation of people living with HIV in WHO meetings on the ART and PMTCT Guidelines in October 2009.The new ART Guidelines are expected in November 2009.
GNP+ would like to acknowledge the support of its partners – Treatment Action Campaign, APN+, and NAM – in undertaking the consultations. GNP+ would like to thank the WHO for its support throughout the process.
Click here to access the consultation reports: