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Realities in Global Treatment of H.I.V.


The World Health Organization recently issued aggressive new guidelines for treating people infected with H.I.V., the virus that causes AIDS. The guidelines are a welcome step forward but fall short of the treatment goals that could and should be set.

The missing ingredient is enough financing by international donors and many afflicted countries to make treatments widely available.

Currently, an estimated 34 million people around the world are infected with H.I.V., mostly in sub-Saharan Africa. About 9.7 million of them are being treated with antiviral drugs that can prolong their lives for decades. Some seven million more were eligible for the drugs under the previous guidelines but are not yet receiving them.

The new guidelines will widen the gap. They recommend that infected people be given antiviral drugs even earlier than is now typical, when a person’s CD4 white blood cell count is relatively high, indicating a still-healthy immune system. The new guidelines make about 26 million people in poor and middle-income countries eligible for the drugs, up from 17 million before.

Ideally, virtually all people known to be infected should get drug treatments immediately, in a single pill, no matter what their CD4 counts.

That would greatly reduce the risk of transmitting the virus to others and prolong lives by preventing deterioration of the immune system.

A vaccine would be surest way to prevent infection because a person would be protected for a substantial number of years, perhaps for a lifetime, without the need take antiviral drugs indefinitely. But an effective vaccine could take years to develop and might be only partially effective. Early drug treatments will remain vitally important for the foreseeable future.


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Information in this article was accurate in July 25, 2013. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.