Guideline to double HIV drug demand in India

July 26, 2010

Sanchita Sharma, Hindustan Times

Vienna, July 18, 2010

Free antiretroviral drugs used to treat people with HIV and AIDS should be given

at an earlier stage of infection to reduce sickness and death, said an

International AIDS Society panel at a six-day International AIDS Conference in

Vienna.

About 2.27 million people were infected with HIV in India in the end of 2008,

the last year for which data is available. Of these, 39 per cent were women and

3.5 per cent children.

The World Health Organisation revised the international treatment cut-off to a

CD4 count of 350 per microlitre of blood—a measure of he body's immune status —

from the earlier 200 in 2009.

The current recommendations — published in the Journal of the American Medical

Association — suggest treatment should start at a CD4 count of 500 cells or less

for people with no symptoms. People with symptoms should be treated irrespective

of CD4 count.

A healthy CD4 count ranges between 1,000 and 1,500 cells per microlitre.

In India, people infected with HIV, the virus that causes AIDS, are treated free

at the government centres when their count of CD4 cells falls to 200 cells or

less per microlitre of blood. Over 3.22 lakh people, including 219,613 children,

were being treated free at 272 antiretroviral therapy centres.

If India follows the new recommendations, the number of people needing treatment

would more than double.

" Making free drugs available to people who need them has saved 6 million lives

since 2002 — 4,000 lives each day. Though infrastructure, doctors and funds

remain challenges, India should continue scaling-up treatment,. said Michel

Kazatchkine, executive director, Global Fund for AIDS, Malaria and Tuberculosis,

which committed $1 billion to India since 2002.

Globally, more than 33 million people are infected with HIV and AIDS, which has

killed 25 million since it was first identified in 1981.

" There is no CD4 cell count threshold at which initiating therapy is

contra-indicated (not advised), " said lead researcher of AIDS

Research Consortium of Atlanta and chairperson of the US branch of the

International AIDS Society. She also recommended treatment for pregnant women,

people older than 60, those co-infected by hepatitis B or C or at high risk for

cardiovascular disease.

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