World Health Organization guidelines should not change the CD4 count threshold for antiretroviral therapy initiation

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dc.contributor.authorGeffen, Nathan
dc.date.accessioned2016-08-26T13:37:47Z
dc.date.available2016-08-26T13:37:47Z
dc.date.issued2013
dc.date.updated2016-08-26T12:25:16Z
dc.description.abstractThe World Health Organization (WHO) currently recommends that HIV-positive adults start antiretroviral therapy (ART) at CD4 counts <350 cells/µl. Several countries have changed their guidelines to recommend ART irrespective of CD4 count or at a threshold of 500 CD4 cells/µl. Consequently, WHO is currently revising its treatment guidelines and considering recommending ART initiation at CD4 counts <500 cells/µl. Such decisions are critically important, as WHO guidelines inform healthcare policies in developing countries and are used by activists in their advocacy work. Changing the CD4 initiation point from 350 to 500 cells/µl would, however, be premature and have profound cost implications on Global Fund, President’s Emergency Plan for AIDS Relief (PEPFAR) and developing country health budgets. We should be willing to campaign for such a change in guidelines despite cost implications, if supported by evidence. However, the evidence remains outstanding.en_ZA
dc.identifierhttp://dx.doi.org/DOI:10.7196/SAJHIVMED.906
dc.identifier.apacitationGeffen, N. (2013). World Health Organization guidelines should not change the CD4 count threshold for antiretroviral therapy initiation. <i>Southern African Journal of HIV Medicine</i>, http://hdl.handle.net/11427/21569en_ZA
dc.identifier.chicagocitationGeffen, Nathan "World Health Organization guidelines should not change the CD4 count threshold for antiretroviral therapy initiation." <i>Southern African Journal of HIV Medicine</i> (2013) http://hdl.handle.net/11427/21569en_ZA
dc.identifier.citationGeffen, N. (2013). World Health Organization guidelines should not change the CD4 count threshold for antiretroviral therapy initiation. Southern African Journal of HIV Medicine, 14(1).en_ZA
dc.identifier.issn1608-9693en_ZA
dc.identifier.ris TY - Journal Article AU - Geffen, Nathan AB - The World Health Organization (WHO) currently recommends that HIV-positive adults start antiretroviral therapy (ART) at CD4 counts <350 cells/µl. Several countries have changed their guidelines to recommend ART irrespective of CD4 count or at a threshold of 500 CD4 cells/µl. Consequently, WHO is currently revising its treatment guidelines and considering recommending ART initiation at CD4 counts <500 cells/µl. Such decisions are critically important, as WHO guidelines inform healthcare policies in developing countries and are used by activists in their advocacy work. Changing the CD4 initiation point from 350 to 500 cells/µl would, however, be premature and have profound cost implications on Global Fund, President’s Emergency Plan for AIDS Relief (PEPFAR) and developing country health budgets. We should be willing to campaign for such a change in guidelines despite cost implications, if supported by evidence. However, the evidence remains outstanding. DA - 2013 DB - OpenUCT DP - University of Cape Town J1 - Southern African Journal of HIV Medicine LK - https://open.uct.ac.za PB - University of Cape Town PY - 2013 SM - 1608-9693 T1 - World Health Organization guidelines should not change the CD4 count threshold for antiretroviral therapy initiation TI - World Health Organization guidelines should not change the CD4 count threshold for antiretroviral therapy initiation UR - http://hdl.handle.net/11427/21569 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/21569
dc.identifier.vancouvercitationGeffen N. World Health Organization guidelines should not change the CD4 count threshold for antiretroviral therapy initiation. Southern African Journal of HIV Medicine. 2013; http://hdl.handle.net/11427/21569.en_ZA
dc.languageengen_ZA
dc.publisherAOSIS, South Africaen_ZA
dc.publisher.departmentCentre for Social Science Research(CSSR)en_ZA
dc.publisher.facultyFaculty of Humanitiesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsCreative Commons Attribution 4.0 International (CC BY 4.0)*
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_ZA
dc.sourceSouthern African Journal of HIV Medicineen_ZA
dc.source.urihttp://www.sajhivmed.org.za/index.php/hivmed
dc.titleWorld Health Organization guidelines should not change the CD4 count threshold for antiretroviral therapy initiationen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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