Start ARVs sooner, says WHO

2008-07-27 00:00

The World Health Organisation (WHO) has recommended that people with HIV should start anti-retroviral (ARV) treatment earlier than they do in South Africa at present.

WHO recommends that people should start on ARVs when their CD4 count drops to 350, rather than to 200 as in the SA public health sector.

The Treatment Action Campaign in KwaZulu-Natal said it supports the recommendation.

Spokeswoman Lihle Dlamini said providing ARVs to pregnant women when their CD4 count reaches 350 would reduce the chances of mother-to-child infection.

Dlamini said delays in the process of getting ARVs increase the risk of opportunistic infections.

“There are long waiting lists at some HIV/Aids sites. People wait for more than a month for the CD4 count test results, and by the time the results are returned, their CD4 count might have dropped to less than 100.”

KZN Health Department spokesman Leon Mbangwa would not confirm whether the WHO recommendations would be adopted. “It is up to the relevant countries to consider these recommendations and to make changes in their guidelines based on the local circumstances.”

However, he said, the ARV guidelines are being reviewed and a draft is “awaiting signatures”.

Mbangwa said the government also takes into consideration the legal and contractual agreements it has with companies supplying drugs to health facilities before making changes to the guidelines.

“An example is that we have recently awarded tenders to companies to supply the tablets. Any change would impact on the contract currently signed with companies concerned.”

He said there are classes to provide counselling “on the treatment regimen patients are about to undertake, the importance of strong social support in order to ensure that they have a person to remind them never to drop out of the treatment, the effects of alcohol, good nutrition and how to manage side-effects”.

Mbangwa said measures have been taken to speed up the process — “recruiting necessary staff, improving infrastructure like additional counselling rooms, offering the service after hours and weekends, and working with NGOs to boost capacity for roll-out”.

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