By Dr Fiona Bisshop
Last month I had the privilege to attend the Eighth International AIDS Society Conference in Vancouver. It was an exciting meeting, with new data being presented in a number of areas including early HIV treatment, Hep C co-infection and PrEP.
On the opening day leading figures endorsed a call for immediate access to antiretroviral therapy for all people upon diagnosis with HIV.
As one professor said “Let this be the conference where the question of when to start treatment stops being a scientific question and starts being a question of finance and political will.”
The Vancouver Consensus Statement has been endorsed by leaders of major agencies including the Global Fund to Fight AIDS, Tuberculosis and Malaria, the US President’s Emergency Plan for AIDS Relief (PEPFAR) and the Joint United Nations Programme on HIV/AIDS (UNAIDS), and is intended to place pressure on donors and governments to support expanded HIV treatment and prevention.
The statement calls for immediate access to antiretrovirals and for access to pre-exposure prophylaxis (PrEP) for those at high risk of HIV exposure, and urges rapid progress towards the implementation of new scientific evidence.
The data from the START study was presented, which looked at early treatment for HIV, and the results confirm that early treatment confers an advantage even if T cell counts are quite high.
The exciting follow-on from this was that the WHO announced that they will issue new HIV treatment guidelines later this year, recommending treatment for everyone living with HIV, regardless of CD4 count. This will present a challenge for those developing countries already struggling to afford the provision of HIV treatment. Australia really is the lucky country in this respect – all the latest treatments are available without restriction, and heavily subsidized so as to be affordable for all.
Of course the key to getting on treatment early is to actually get tested and know your status – another good reason to have regular HIV tests!
The new WHO guidelines are also going to recommend that PrEP (pre-exposure prophylaxis) be made available to all people who are at risk of HIV. PrEP is still not licensed here in Australia but it is legally obtainable via overseas pharmacies – see your doctor to discuss whether PrEP is right for you.