Tuesday June 24 2014

Government adopts new guidelines on ARVs



Negative HIV partners in discordant relationships will be enrolled on antiretroviral treatment after the government adopted World Health Organisation (WHO) guidelines this year. WHO revised the guidelines last year as a preventive measure and it was upon individual governments to implement them.

According to Dr Peter Mudiope, the Uganda Aids Commission head of HIV prevention, because studies have shown that ARVs can reduce the amount of viral load in a person’s body by stopping HIV from replicating, the government has this year, adopted new guidelines for giving ARVs to all infected HIV persons whose CD4 count is 500 and below.

Also, all persons with HIV and TB co-infection, all pregnant HIV positive women and all children newly diagnosed with HIV will be put on ARVs.

Dr Mudiope urged that this will reduce on the number of new infections since research has established that HIV-infected persons on ARVs are less likely to transmit the virus to another person. CD4 count is a test measure doctors use to find out the strength of one’s immune system.

“The government has adopted new guidelines to give ARVs to HIV/Aids infected persons with cutoff that every person of 500 CD4 count and below should start ART. All discordant couples, all pregnant positive women and all newly diagnosed children should be on ARTs,” Dr Mudiope said in an interview.

“By saying that we give ARVs to as many people as the new policy suggests, we hope their viral load will go down and ability to transmit HIV to another person reduces. What makes a person susceptible is the amount of virus in the blood. That is why we are aiming at reducing the virus in the blood. If we are able to reduce viruses in one’s body by 90 per cent, it means we can reduce new infections by 90 per cent.”

However, Dr Mudiope is skeptical that implementing such a strategy will increase costs and risks amid declining international funding for HIV programmes to developing countries.

“You don’t have to know their CD4 count. Now based on these guidelines, how many people will need ARVs? Almost everybody will need ARVs. But are there ARVs enough?”
Mr Dan Kimosho, the National Medical Stores spokesperson, yesterday confirmed that the country has the capacity to supply ARVs to all the patients as long as there is ‘early and good’ planning.

“If we were able to get clear statistics of who needs ARVs, we would plan ahead and get the required quantities. ARVs are manufactured in Uganda. The challenge goes back to planning and the patient’s attitude,” Mr Kimosho said in a telephone interview.

Dr Mudiope reported that at least 77 per cent of the 1.4 million people infected with HIV virus were enrolled on ARVs last year based on the national CD4 count of 350 and below guidelines. However, this has reduced to 42.3 per cent people on ARVs using the new guidelines.