Vienna: The UN`s World Health Organisation
(WHO) Monday issued the first overhaul of its guidelines on HIV
drugs in four years, saying the therapy now saving more than
five million lives should be initiated at an earlier stage of
A phonebook-sized volume issued at the International AIDS
Conference in Vienna confirmed and amplified a key
recommendation made by the UN agency last year about earlier
use of antiretroviral therapy (ART).
The 156-page report highlighted the leading role played
by the famous drug "cocktail" in fighting the human
immunodeficiency virus (HIV) which causes AIDS.
The combination therapy, which was first introduced in
1996 but initially restricted to rich countries because of its
then high cost, reached 5.2 million people in 2009, an
increase of 1.2 million over 2008, the report said.
At least 4.3 million other poor, badly-infected people
still need access to the treatment, according to a 2008 count.
In 2006, the WHO advised drug initiation when the tally
CD4 cells -- the key immune cells targeted by HIV -- reached
200 cells or less per microlitre of blood, a stage that meant
a patient`s immune system had already been badly weakened by
In 2009, citing evidence about the drugs` effectiveness
and safety, the agency raised the figure to 350 CD4 cells per
microlitre of blood, which thus means at an earlier stage of
This recommendation is spelled out in the new report, along with many other guidelines on drug use, including
second-line therapy if a first course of treatment fails.
"All adolescents and adults including pregnant women with
HIV infection and CD4 counts of 350 cells/mm3, should start
ART, regardless of the presence or absence of clinical
symptoms," said the report.