Revised guidance on HIV treatment and care published

WHO/Europe has revised two clinical protocols on the treatment of and care for people living with HIV, providing recommendations on patient evaluation and evidence-informed antiretroviral treatment for adults and adolescents, and the management of hepatitis B and HIV coinfection.

Following new and important evidence on approaches to treatment and care of HIV infection, in 2010 WHO issued new global recommendations on:

  • antiretroviral therapy for adults and adolescents, and for infants and children; and
  • the use of antiretrovirals to treat HIV-infected pregnant women and their babies.

In the WHO European Region, countries in eastern Europe and central Asia have similar trends in and prevalence of HIV in different key populations that are at higher risk of HIV exposure and transmission. Although these countries often have limited resources to respond, their health-care systems and resources are better organized and equipped than those in many other such countries outside the European Region.

While global WHO recommendations cover key global issues, they often need adaption for the regional and country level, to reflect regional context, existing infrastructure and health-care systems’ capacities. WHO/Europe is therefore revising its clinical protocols on HIV/AIDS treatment and care, first issued in 2007.

Patient evaluation and antiretroviral treatment

Providing antiretroviral treatment (ART) is the core component of treatment and care of people living with HIV. Considering the varying capacity of the countries in the Region to provide ART, the first clinical protocol, “Patient evaluation and antiretroviral treatment for adults and adolescents”, provides evidence-informed recommendations suggesting preferable, alternative and acceptable options for ART regimens for adolescents and adults. This approach allows countries to choose recommendations appropriate to the available resources.

Management of hepatitis B and HIV coinfection

The hepatitis B virus (HBV) and HIV have common routes of transmission, but HBV is about 100 times more infectious. People coinfected with HIV and HBV are at increased risk of liver-related mortality. A few antiretroviral drugs are effective in treating both problems. The seventh protocol, “Management of hepatitis B and HIV coinfection”, provides algorithms of diagnosis and evidence-informed treatment options that consider countries’ diverse resources and capacities.

Three other regional protocols are being revised for release in 2012:

  • Protocol 4. Management of tuberculosis and HIV coinfection;
  • Protocol 10. Prevention of HIV transmission from HIV-infected mothers to their infants; and 
  • Protocol 11. Paediatric HIV and AIDS treatment and care.