HIV/AIDS: SA moving to earlier treatment

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It is not a matter of if SA will move to earlier HIV treatment, but when. [s]Health-e[/s] reports that this is according to Dr Aaron Motsoaledi, [b]SA Health Minister[/b], who said: ‘We are very serious about it – we have always taken our cue from the [b]World Health Organisation (WHO)[/b]. Since (their new guidelines) have been announced, we accepted it as the direction where we are going to go.’ In 2013, the WHO issued new HIV treatment guidelines recommending countries start HIV patients on antiretrovirals (ARVs) sooner – when their CD4 counts, a measure of the immune system’s strength, fell below 500. The report says results like these have bolstered a growing body of observational data that earlier treatment benefited HIV patients by keeping them healthier longer. But, the report notes, the proposed move to earlier treatment has been controversial with local clinicians cautioning the benefit to patients has not yet been proven and that it may increase ARV resistance in a country where about 40% of ARV patients cannot be traced after three years of being on ARVs.

The recently released [b]2012 South African National HIV Prevalence, Incidence and Behaviour Survey Report[/b] brought to light the worrying realities of HIV infection in SA, while emphasising the human and social dimensions of the epidemic, says Derek Hanekom, [b]SA’s Minister of Science and Technology[/b] in a [s]Polity[/s] report. He said information from the report could be used to improve social and behavioural change campaigns, and help to identify structural aspects that deserve special attention. A renewed focus on creating awareness about risky behaviour and measures to strengthen the HIV testing campaign must be taken. However, this would require sociological knowledge on how communities understand and react to interventions, and adapt their behaviour according to new awareness.

Sub-Saharan Africa, despite all the impressive gains, still shoulders a vastly disproportionate burden of the epidemic, writes Dr Olive Shisana CEO of the [b]Human Sciences Research Council[/b], in the [s]Mail & Guardian[/s]. ‘One needs to be mindful when generalising statistics. The “good news” about declining new HIV infections and Aids deaths is not shared evenly across regions or countries.’The idea of giving colourful and flavoured c ondoms to tertiary institutions has been welcomed by the [b]Higher Education and Training HIV/Aids Programme[/b] (HEAIDS). HEAIDS director Ramneek Ahluwalia said in a [s]Health24[/s] that many students joined the higher education and training facilities from the age of 15 and encouraging c ondom use among tertiary students was a good place to start. ‘If c ondom use is indeed falling, then it is falling among students too. So it is our duty to ask what will enable students and youth in general to protect themselves, and if blue or strawberry-flavoured c ondoms are the means to it, then we must do it.’

Meanwhile, drugs currently given to prevent organ rejection after a transplant, may offer a new approach to curing HIV. [s]News-Medical[/s] reports that in a study of HIV patients who underwent kidney transplant, drugs that were given to stop rejection of the new organs were also found to keep HIV under control. The findings suggest the drugs modify the immune system in such a way that reduces the persistence of the virus, according to the [b]University of California, San Francisco[/b] team. The [s]American Journal of Transplantation[/s] analysis showed that long-term exposure to the drugs kept the patients’ HIV well under control. Of particular interest was an agent called sirolimus, as patients who took this drug had a decrease in the number of HIV-infected cells over time.

Full Health-e report
WHO guidelines
Full Polity report
Full M&G article
Full Health24 report
Full News-Medical report
AJT abstract


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