WHO 'Treatment as Prevention' guidelines are unlikely to decrease HIV transmission in the UK unless undiagnosed HIV infections are reduced

AIDS
Alison E BrownValerie C Delpech

Abstract

The WHO guidelines recommend antiretroviral therapy (ART) begins when CD4 cell counts reach less than 500 cells to reduce HIV transmission. In the UK, 96 000 people were living with HIV (PLWHIV) in 2011, ART coverage was 84% among the diagnosed population and 42% of PLWHIV had detectable viraemia. Using published methods, we estimate starting ART at below 500 CD4 cells could have reduced the proportion of PLWHIV with detectable viraemia from 42% to 38%, whereas halving the undiagnosed population could have led to a decrease to 28%. In the UK, it is unlikely early treatment will reduce HIV transmission unless the undiagnosed population is substantially reduced.

References

Jul 20, 2011·The New England Journal of Medicine·Myron S CohenUNKNOWN HPTN 052 Study Team

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Citations

Oct 7, 2014·Current HIV/AIDS Reports·David N BurnsFulvia Veronese
Sep 21, 2015·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Alex MarzelS Yerly
Sep 5, 2014·Archives of Disease in Childhood·Alasdair Bamford, Hermione Lyall
Nov 5, 2015·BMC Infectious Diseases·D Van BeckhovenUNKNOWN BREACH Belgian Research on AIDS and HIV Consortium
Aug 20, 2016·International Journal of STD & AIDS·Stephen C DaviesSuran L Fernando
Nov 13, 2014·Current Opinion in HIV and AIDS·Praphan Phanuphak, Ying-Ru Lo
Sep 20, 2016·British Journal of Hospital Medicine·S KellyN Vaid
Sep 16, 2019·AIDS Research and Therapy·Patrick DakumNicaise Ndembi

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