On the day before World AIDS Day 2009,

On the day before World AIDS Day 2009, the World Health Organization (WHO)released its new HIV treatment guidelines. Included in the new HIV treatment guidelines are:

• CD4 thresholds for starting medication regimens;
• preferred medications when building an HIV regimen;
• ways to further reduce the risk of HIV transmission from mother to child;
• and HIV treatment guidelines for taking medications while breastfeeding.

Here is a summary of the latest HIV treatment guidelines.

Start HIV Treatment at Higher CD4 Counts

HIV treatment should be started on all people with a CD4 count less than or equal to 350 regardless of the presence or absence of symptoms. In comparison, in 2006 WHO recommended treatment when the CD4 count fell below 200. Since then data accumulated from clinical trials and clinical research have shown that starting HIV medications earlier, when CD4 counts are higher, reduces illness and progression of HIV to AIDS.

Phase Out Older Medications

The WHO HIV treatment guidelines recommended phasing out the use of older HIV medications that have been found to have long term side effects. Medications such as Zerit (stavudine) are to be phased out of initial regimens because of toxic side effects like lactic acidosis. In developing nations where medications are hard to come by, Zidovudine (AZT) and Viread (tenofovir) are more affordable recommendations to replace Zerit. Keep in mind that while their toxic profile may be less, they are not without risk; for example Viread has been linked to toxic kidney side effects in some people. In the Western World, it is recommended that the newest medications be used because of their low side effect profiles.