A World Health Organisation (WHO) report, which is to presented at the XIX International AIDS Conference in Washington, DC on Sunday, is to advocate for a “strategic use” of antiretroviral treatment (ART) to significantly reduce transmission of HIV.
The recommendation stems from the results of a large, multi-country study conducted last year by the HIV Prevention Trials Network on discordant couples (when one partner is HIV-positive and the other is not). The study found the strategic use of antiretroviral treatment (ART) on the HIV negative person cut transmission of HIV by 96%. This is commonly known as a treatment as prevention approach.
Dr Margaret Chan, WHO’s director general, said: “Every year, more than a million more people in low- and middle- income countries start taking antiretroviral drugs. Further scale-up and strategic use of the medicines could radically change this.
“We now have evidence that the same medicines we use to save lives and keep people healthy can also stop people from transmitting the virus and reduce the chance they will pass it to another person.”
However, the report also flags up how the increased use of antiretrovirals (ARVs) in low-and middle-income countries has resulted in resistance to some forms of treatment, although not at levels as high as the 1990s when HIV medication was first introduced.
The WHO’s findings indicate that the 6.8% of HIV among people initiating treatment in the areas surveyed are resistant to ARVs. This is a lower rate than in high income countries where drug resistant HIV stands at 8-14%, depending on region. A number of factors have helped keep down levels of drug resistance in low-and middle-income countries. These include good programme management and the use of simpler, more effective combinations of ARVs than those originally introduced in high-income countries in the 1990s.
Dr Gottfried Hirnschall, director of the WHO’s HIV department, said when people take ARVs the amount of HIV in their body is decreased making them less likely to transmit the virus to others.
“If we can get, and keep, more people on treatment, and reduce their virus levels, we can reduce the number of new people who are infected,” Dr Hirnschall said.
