The 2013 WHO guidelines for antiretroviral therapy: Evidence-based recommendations to face new epidemic realities

Meg Doherty, Nathan Ford, Marco Vitoria, Gundo Weiler, Gottfried Hirnschall

Research output: Contribution to journalReview articlepeer-review

Abstract

PURPOSE OF REVIEW: The review summarizes the key new recommendations of the WHO 2013 guidelines for antiretroviral therapy and describes the potential impact of these recommendations on the HIV epidemic. RECENT FINDINGS: The 2013 WHO guidelines recommend earlier initiation of antiretroviral therapy (ART) at CD4 500 cells/μl or less for all adults and children above 5 years. Further recommendations include initiation of ART irrespective of CD4 cell count or clinical stage for people co-infected with active tuberculosis disease or hepatitis B virus with severe liver disease, pregnant women, people in serodiscordant partnerships, and children under 5 years of age. The ART regimen comprising a once daily fixed-dose combination of tenofovir + lamivudine (or emtricitabine) + efavirenz is recommended as the preferred first-line therapy. Several approaches are also recommended to reach more people and increase health service capacity, including community and self-testing, and task shifting, decentralization, and integration of ART care. SUMMARY: If fully implemented, the 2013 WHO ART guidelines could avert at least an additional 3 million deaths and prevent close to an additional 3.5 million new infections between 2012 and 2025 in low- and middle-income countries, compared with previous treatment guidelines.

Original languageEnglish (US)
Pages (from-to)528-534
Number of pages7
JournalCurrent opinion in HIV and AIDS
Volume8
Issue number6
DOIs
StatePublished - Nov 1 2013
Externally publishedYes

Keywords

  • Public health approach
  • Simplification
  • Strategic use
  • antiretroviral therapy

ASJC Scopus subject areas

  • Immunology
  • Hematology
  • Oncology
  • Oncology(nursing)
  • Infectious Diseases
  • Virology

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