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LETTER TO THE EDITOR
Year : 2020  |  Volume : 18  |  Issue : 4  |  Page : 345-346

Status and role of antiretroviral therapy in the treatment of HIV: World Health Organization


1 Member of the Medical Education Unit and Institute Research Council, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpaet District, Tamil Nadu, India
2 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpaet District, Tamil Nadu, India

Date of Submission11-Mar-2020
Date of Decision12-Mar-2020
Date of Acceptance30-Mar-2020
Date of Web Publication19-Oct-2020

Correspondence Address:
Dr. Saurabh RamBihariLal Shrivastava
Professor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) – Deemed to be University, Tiruporur - Guduvancherry Main Road, Ammapettai, Nellikuppam, Chengalpaet District, Tamil Nadu - 603 108
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/cmi.cmi_31_20

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How to cite this article:
Shrivastava SR, Shrivastava PS. Status and role of antiretroviral therapy in the treatment of HIV: World Health Organization. Curr Med Issues 2020;18:345-6

How to cite this URL:
Shrivastava SR, Shrivastava PS. Status and role of antiretroviral therapy in the treatment of HIV: World Health Organization. Curr Med Issues [serial online] 2020 [cited 2020 Nov 26];18:345-6. Available from: https://www.cmijournal.org/text.asp?2020/18/4/345/298589



Dear Editor,

HIV has been acknowledged as one of the major public health concerns for more than three decades now, and this is predominantly because of its high incidence and large number of deaths attributed to the infection.[1],[2] In fact, the infection has accounted for the death of more than 32 million people till date, while close to 38 million people are living with the infection.[1] In the absence of availability of a curative option, the antiretroviral therapy (ART) has played a major role in reducing the viral load as well as in improving the quality of life of the affected individuals.[2],[3]

As a matter of fact, between 2000 and 2018, new HIV infections fell by 37% and HIV-related deaths fell by 45%.[1] This transforms to saving lives of more than 11 million people in the mentioned time-span and clearly suggests that it is the outcome of the concerted actions of the involved stakeholders.[1],[2] Further, the coverage of ART among HIV-infected pregnant and lactating women has been reported as 80% in the last year, and this also is an indicator that consistent efforts have been taken to increase the accessibility to the therapy.[1],[3]

The significant progress in the treatment delivery is predominantly because of the adoption of two major recommendations by the World Health Organization, including initiation of ART in all individuals diagnosed with HIV infection regardless of their CD4 count and administration of prophylactic ART to high-risk groups of individuals.[4] The strategy of early initiation of the therapy has accounted for improved survival rates and reduced potential risk of transmission of the infection to their partners.[3],[4] The available figures reflect that close to 22 million people were initiated on therapy in 2017 alone worldwide, and this is a definite positive sign.[1],[4]

Nevertheless, it is extremely important to remember that ART cannot alone substitute the other essential strategies, including strict compliance to the therapy, promotion of HIV self-testing, counseling and supportive services, and easy access to condom or safe injections.[1],[2],[3],[4],[5] In addition, still, a lot needs to be done to meet the proposed 90-90-90 targets, in terms of adoption of self-testing in all the nations, lifelong ART delivery for pregnant women, the adoption of dolutegravir as a first- and second-line treatment regimen, and periodic monitoring of viral load.[4],[5]

Moreover, there are two important considerations; the first being that the recommendations proposed by the World Health Organization have to be modified based on the local needs, as they are general recommendations. Second, it is important to realize that if the government fails to ensure complete and long-term supply of ARTs, then it will do more harm than good due to the development of drug-resistant strains. Further, there is an immense scope to invest in research activities and bridge the existing gaps in the delivery of therapy.[1]

In conclusion, owing to the consistent efforts, a lot of progress has been made in enhancing the reach of ART among HIV-infected individuals. However, we have to continue our actions to ensure that the quality of life of people living with HIV is significantly improved.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
World Health Organization. HIV/AIDS – Fact Sheet; 2019. Available from: https://www.who.int/en/news-room/fact-sheets/detail/hiv-aids. [Last accessed on 2020 Mar 11].  Back to cited text no. 1
    
2.
Shrivastava SR, Shrivastava PS, Ramasamy J. Responding to the World Health Organization call for ensuring accessibility to antiretroviral therapy for all. Ann Trop Med Public Health 2016;9:288-9.  Back to cited text no. 2
  [Full text]  
3.
World Health Organization. Treat all: Policy adoption and implementation status in countries – Fact Sheet; 2018. Available from: http://apps.who.int/iris/bitstream/handle/10665/275468/WHO-CDS-HIV-18.21-eng.pdf?ua=1. [Last accessed on 2020 Mar 11].  Back to cited text no. 3
    
4.
World Health Organization. Guideline on when to start antiretroviral therapy and on pre-exposure prophylaxis for HIV. Geneva: WHO Press; 2015. p: 1-24.  Back to cited text no. 4
    
5.
STAR Initiative, Unitaid and World Health Organization. Knowing your status: Then and now – Realizing the potential of HIV self-testing. Geneva: WHO Press; 2018. p: 1-6.  Back to cited text no. 5
    




 

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