| Specific Detail Info |
The majority of new HIV infections occur in sub-Saharan Africa
and other developing countries with scarce financial resources and meagre health
system infrastructure. Expansion of Antiretroviral Therapy (ART) may overwhelm
health services capacity, result in suboptimal care, and divert attention
from crucial preventive measures. A 2009 WHO guideline recommends
earlier initiation of ART for adults and adolescents, treatment at CD4 counts
of 350 cells/mm3 along with universal testing. For sub-Saharan Africa, WHO
previously recommended a threshold of 200 cells/mm3. Despite vast potential
benefits of early ART initiation at individual and community levels, it does not
necessary follow that clinical experience in industrialised countries can be
replicated in resource-limited settings with moderate to high HIV burdens.
Adherence to the 2009 WHO guidelines is unlikely to be sustainable without
guarantees of adequate national and donor support – something all developing
countries need to consider before adoption of the new policy. |
