7.1 When to start ART

Consolidated ARV guidelines, June 2013

Early treatment initiation is associated with clinical and HIV prevention benefits, improving survival and reducing the incidence of HIV infection at the community level. The 2013 Guidelines Development Group recommends that national HIV programmes provide ART to all people with a confirmed HIV diagnosis with a CD4 count of 500 cells/mm3 or less, giving priority to initiating ART among those with severe/advanced HIV disease (see Annex 1) or a CD4 count of 350 cells/mm3 or less.

It is also recommended to initiate ART in people with active TB disease and HBV coinfection with severe liver disease, all pregnant and breastfeeding women with HIV, all children younger than five years living with HIV and all individuals with HIV in serodiscordant relationships, regardless of CD4 cell count (Table 7.1).