n Southern African Journal of HIV Medicine - Southern African HIV Clinicians Society adult antiretroviral therapy guidelines : update on when to initiate antiretroviral therapy : guidelines
|Article Title||Southern African HIV Clinicians Society adult antiretroviral therapy guidelines : update on when to initiate antiretroviral therapy : guidelines|
|Journal||Southern African Journal of HIV Medicine|
|Affiliations||1 University of Cape Town, 2 University of Cape Town, 3 University of Cape Town, 4 University of Cape Town, 5 Livingstone Hospital, 6 University of the Witwatersrand, 7 University of KwaZulu-Natal, 8 University of KwaZulu-Natal, 9 University of KwaZulu-Natal, 10 Wits Reproductive Health and HIV Institute, 11 Wits Reproductive Health and HIV Institute and 12 Amathole District Clinical Specialist Team|
|Publication Date||Apr 2015|
|Pages||1 - 4|
The most recent version of the Southern African HIV Clinicians Society's adult antiretroviral therapy (ART) guidelines was published in December 2014. In the 27 August 2015 edition of the New England Journal of Medicine, two seminal randomised controlled trials that addressed the optimal timing of ART in HIV-infected patients with high CD4 counts were published: Strategic timing of antiretroviral therapy (START) and TEMPRANO ANRS 12136 (Early antiretroviral treatment and/or early isoniazid prophylaxis against tuberculosis in HIV-infected adults). The findings of these two trials were consistent: there was significant individual clinical benefit from starting ART immediately in patients with CD4 counts higher than 500 cells/µL rather than deferring until a certain lower CD4 threshold or clinical indication was met. The findings add to prior evidence showing that ART reduces the risk of onward HIV transmission. Therefore, early ART initiation has the public health benefits of potentially reducing both HIV incidence and morbidity. Given this new and important evidence, the Society took the decision to provide a specific update on the section of the adult ART guidelines relating to when ART should be initiated.
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