International group urges prompt HIV treatment for all

An international group of scientists on Sunday called for all adults who test positive for HIV to be treated with antiretroviral drugs right away rather than waiting for their immune systems to weaken. The recommendations by the International Antiviral Society are the first by a global group to make such a call, and were released at the 19th International AIDS Conference in Washington, the world's largest meeting on HIV/AIDS. Other major groups, such as the World Health Organization, currently urge treatment after the disease progresses to a certain point, or when the body's T-cells, or CD4 count, reaches or falls below the level of 350 cells/mm3. "These guidelines are aspirational," said Melanie Thompson, a doctor with the AIDS Research Consortium of Atlanta, urging increased testing and better care of those who test positive for HIV. The guidelines are based on new trial data and drug regimens that have become available in the last two years which warrant an "update to guidelines for antiretroviral treatment in HIV-infected adults in resource-rich settings." Some 34 million people in the world are living with HIV, according to the latest UNAIDS report issued last week. However, about one in five people are not aware of their status and are most at risk of spreading the disease. Some eight million people in low and middle income countries are now on antiretroviral treatment, making up about half of those in the world who need it, the UNAIDS report said. "Unfortunately most people in the world are not going to benefit from our guideline recommendations," Thompson said, noting that most people seek care too late, by the time they already have full-blown AIDS. Asked by a reporter if the guidelines were realistic in the current global cash-crunch environment, Thompson replied: "I actually reject the idea that there is not enough money for care and for drugs for antiretroviral therapy. "I think it is a matter of political will. I think it is a matter of prioritizing and recognizing that treatment of HIV is cost-effective. It may be cost-saving as well," she said. "The science should drive the allocation of resources and guidelines can play an important role in that respect." The full guidelines are published in Sunday's theme issue of the Journal of the American Medical Association, which focuses on HIV/AIDS.