Researchers have suggested that treatment of patients with HIV infections in South Africa should start at higher CD4 cell counts.
After studying untreated patients in the Cape Town area, they have identified a greater short-term risk of progression to Aids or death in South African patients with CD4 cell counts of 200-350 cells, compared to European and Australian patients with similar values and at the same clinical stage of the disease.
Their findings, published in the British medical journal The Lancet, were reported by the international AidsMap organisation on Monday.
The report noted that World Health Organisation (WHO) guidelines for the start of antiretroviral (ARV) therapy had been formulated after studies carried out in high-income countries and assessing mostly the long-term risk of disease progression.
Recommendations for lower-income countries had focused on CD4 cell counts, with treatment starting at CD4 values of less than 200.
The Cape Town study concluded that, due to the scarcity of laboratory and clinical tools to assess disease progression in sub-Saharan Africa, both the short-term risk of HIV/Aids and the short-term risk of death should be considered for the start of ARV therapy.
They hoped for the revision and refinement of WHO guidelines to start treatment at levels above 200, which they suggested could lead to the prevention of two-thirds of early deaths in patients in resource-limited settings.
There was also an AidsMap report published on Monday that said an emergency HIV/Aids drug supply service is to open in South Africa which will also serve other sub-Saharan countries.
Funded and initiated by the Dutch Ministry of Foreign Affairs and Development Cooperation, a buffer stock maintained in South Africa will offer a fall-back service to HIV/Aids treatment programmes in the region.
The service will be able to supply 80% of sub-Saharan Africa destinations within one week. Stocks will include generic — usually cheaper — versions of drugs patented in South Africa. – Sapa