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

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

Research output: Contribution to journalArticle

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 2013
Externally publishedYes

Fingerprint

Guidelines
Tenofovir
efavirenz
Therapeutics
Lamivudine
Politics
CD4 Lymphocyte Count
Hepatitis B virus
Health Services
Liver Diseases
Pregnant Women
Tuberculosis
HIV
Infection

Keywords

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

ASJC Scopus subject areas

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

Cite this

The 2013 WHO guidelines for antiretroviral therapy : Evidence-based recommendations to face new epidemic realities. / Doherty, Meg Caroline; Ford, Nathan; Vitoria, Marco; Weiler, Gundo; Hirnschall, Gottfried.

In: Current Opinion in HIV and AIDS, Vol. 8, No. 6, 11.2013, p. 528-534.

Research output: Contribution to journalArticle

Doherty, Meg Caroline ; Ford, Nathan ; Vitoria, Marco ; Weiler, Gundo ; Hirnschall, Gottfried. / The 2013 WHO guidelines for antiretroviral therapy : Evidence-based recommendations to face new epidemic realities. In: Current Opinion in HIV and AIDS. 2013 ; Vol. 8, No. 6. pp. 528-534.
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