The South African government’s announcement that it will give antiretroviral medication to people with HIV who have CD4 counts of below 350 will save lives and prevent infection.
This is according to Medecins Sans Frontieres (MSF), which welcomed the announcement made by Deputy President Kgalema Motlanthe on Friday (12 August).
Until Friday, people were only able to get ARVs if their CD4 count was below 200 unless they were pregnant or had tuberculosis.
‘The decision to start people on HIV treatment earlier, before they become sick with diseases like tuberculosis, marks a critical moment for this country that is so hard hit by the epidemic,’ said Dr Gilles van Cutsem, Medical Coordinator for MSF in South Africa.
‘When people are started earlier on ARV treatment, they are less likely to die, less likely to become ill, less likely to need hospitalisation and more likely to stick to their treatment in the long run.’
A study conducted by MSF last year in Lesotho found that patients who started treatment above CD4 200 were 68% more likely to survive than patients those who started ARVs when their CD4 count was below 200.
Van Cutsem added that starting people on ARVs earlier was likely to prevent new infections as ‘ARV treatment dramatically reduces the spread of the virus to others, by making people living with HIV less infectious by up to 96 percent’.
Meanwhile, a study published in PloS journal in July predicts that making ARVs available to people from CD4 of 350 would have a dramatic effect on the community of Hlabisa in northern KwaZulu-Natal.
Using mathematical modelling, the researchers, headed by Jan Hontelez of the Africa Centre, found that one-fifth of the community would be living with HIV by 2040 if only those with CD4 below 200 received ARVs. In contrast, only 14 percent of people would be HIV positive if treatment was given to people with CD4 of 350.
In addition, the researchers found that including people from CD 350 would add seven percent in costs for the first five years, but reach almost 30 percent more patients. After 16 years, the additional costs of the programme would ‘reach a break-even point’ when combined with the benefits. ‘ Health-e News Service.