This guide provides new and updated recommendations on the use of point-of-care tests in children under 18 months of age and point-of-care tests to monitor treatment in living people. the HIV; the handling analysis algorithm; and timing of antiretroviral therapy (ART) among people living with HIV who are being treated for tuberculosis.
New proposals launched today outline key new actions countries can take to improve the delivery of HIV testing, treatment and care services by providing greater options for approaches. such as, supporting HIV treatment starting in the community, ensuring children are diagnosed and treated early, and that viral load treatment monitoring is more accessible, focused and stimulating clinical action.
These recommendations make it clear that there is now evidence that the integrated delivery of HIV, TB, NCDs, mental health and sexual and reproductive health services will be required to achieve our goals to end AIDS. as a public health issue by 2030. “
Dr Meg Doherty, Director, WHO Global HIV, Hepatitis and STI Programs
These new recommendations are an update of the WHO WHO 2016 Consolidated Guidelines on the use of ARV drugs for the treatment and prevention of HIV infection. Since the 2016 version was released, WHO has provided updates in several areas of this guidance – antiretroviral options for first and second line treatment, infant diagnosis, post-exposure prophylaxis, advanced HIV infection and the management of cryptococcal diseases and delivery of HIV services.
The COVID-19 pandemic has presented particular challenges for the continuity of HIV care, and it is critical to ensure that the progress of the last decade is not sustained. WHO remains committed to ensuring principles for people-centered care, harmony and simplification, within a public health approach, to allow fair, evidence-based guidelines to lead to more impact on health.
Following an extensive follow-up process, WHO convened two lead development groups that met in almost September and October 2020 to formulate recommendations and implementation considerations. The lead development groups included people living with HIV, policymakers from the Ministry of Health, researchers and health care providers.
WHO now strongly suggest:
- Point of care (POC) nuclear acid test was used to test for HIV in infants and children under 18 months of age.
- To start ART as soon as possible within two weeks of starting TB treatment, regardless of CD4 cell count, for adults, adolescents, children and infants living with HIV.
- People should be given a clinical visit to ART for at least 6 months and respond well, every 3 to 6 months, preferably every six months, if possible.
- People on ART should be offered a recurrence of ART for at least 6 months and that responds well, lasting 3 to 6 months, preferably six months, if possible.
- HIV programs should implement interventions to track people who have separated from care and provide support for relapse.
- Socio-social interventions should be given to all adolescents and young adults living with HIV.
- Function sharing of sample collection and point-of-care (POC) testing with non-laboratory staff should be implemented where the capacity of professional staff is limited.
WHO now nostalgically suggest:
- Point of care (POC) viral load testing can be used to monitor treatment among people living with HIV receiving ART.
- ART initiation can be offered outside of the health facility.
- Sexual and reproductive health services, including contraception, can be integrated within HIV services.
- Diabetes care and hip tolerance can be integrated with HIV services.
The management development groups developed good practice reporting for HIV service delivery and reviewed the treatment monitoring algorithm for people living with HIV.
These clinical and service delivery recommendations are being launched and published independently today for rapid deployment and accessibility by the Ministry of Health, HIV program managers, civil society members and other stakeholders. In July 2021, WHO will update the Consolidated HIV Guidelines and incorporate all new and old recommendations into one easy-to-use guidance document.
WHO would like to thank the experts who shared their valuable time contributing to these updates during the global COVID-19 crisis and we dedicate this work to all a frontline health care worker who responds and succeeds in combating the public health crisis. of HIV and COVID-19.
Source:
World Health Organization