ARV at CD4 cell counts of 350 is better then starting at counts of 200

July 21, 2009

Dear FORUM,

The majority of the scientists participating in the 5th IAS Conference on HIV

Pathogenesis, Treatment and Prevention here at Cape Town , South Africa are of

the opinion that starting ARV treatment at CD4 cell counts of 350 is better than

starting at counts of 200. They say that the annual cost of caring for someone

who starts treatment late in the course of disease (with a CD4 cell count of

less than 50) is twice as high as the cost of care for someone who began

treatment earlier.

More than 5,000 AIDS researchers, implementers and community leaders present in

the conference have also warned of dire public health consequences resulting

from a retrenchment on the global fight against AIDS.

" Despite the recession, the global response to HIV – including the commitment of

sufficient resources to achieve universal access to HIV prevention and

treatment, fully fund AIDS research and strengthen underlying health systems –

cannot be put in a holding pattern, " said IAS President Dr. Julio Montaner in

his opening remarks. He added that retrenchment now would be catastrophic for

the nearly 4 million people who are on treatment in resource-poor countries not

to mention the 6 million others already at critical CD4 threshold of 200 cells

still waiting for the life-saving treatment.

He also blasted on leaders of the most industrialized nations for not

recommitting themselves to the fight against HIV/AIDS during the last G8 meeting

they held in L'Aquila , Italy. Dr Julio Montainer said it was a 'pathetic

mistake' for G8 leaders to have been silent on the matter, a year away to the

time when the world expected to hear of achievements on the targets they had

earlier set----having the epidemic substantially reduced by 2010.

In 2003, the WHO set an ambitious target: three million people living with

HIV/AIDS in low and middle-income countries would be treated with

life-prolonging antiretroviral treatment (ART) by the end of 2005. This was a

step towards achieving the G-8 goal set in July 2005, namely to come as close as

possible to universal access by 2010.

The conference is also witnessing the activists who are of the opinion that the

People living with HIV are to be consulted on the development of new World

Health Organization treatment guidelines for low- and middle-income settings,

due to be released in November.

Dr. JASVINDER SEHGAL

e-mail: <jasvindersehgal@...>

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