Operational Guidance in the 2013 WHO consolidated antiretroviral guidelines
Commentary from AIDS supplement: 2013 WHO Consolidated Guidelines on the use of Antiretroviral drugs: Evidence and Implementation
The new guidelines promote initiating ARVs with a CD4þ T-cell threshold of 500 cells/ml or less for adults, adolescents, and older children. These guidelines further recommend ARVs, regardless of CD4þ T-cell count, for patients with active tuberculosis (TB), pregnant and breastfeeding women, and children younger than 5 years of age.
This is a call for action to countries to further scale up provision of ARVs in addition to improving patient retention along the continuum of care. Such ambitious goals are quite challenging to operationalize in many settings, especially in countries with high HIV burden and weak health systems. This is only possible by optimizing available human and financial resources, ensuring adequate links between care and treatment services, supporting adherence to ARVs, and maximizing retention of patients across the continuum of care.