Important note: Information in this article was accurate in 2008. The state of the art may have changed since the publication date.
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Voice of America - October 27, 2008
Carole Gombakomba
Conclusions of a U.S. study recommending that the HIV-positive people begin taking antiretroviral drugs sooner than has been practiced to date has been well received by AIDS activists in Zimbabwe, where something like one in five adults are estimated to have been infected, but the government is not ready to act on the findings.
The study found that "delaying treatment until a patient's immune system is badly damaged almost doubles the risk of dying in the next few years" compared with the result when patients begin ARV treatment sooner.
Dr. Anthony Fauci, director of the U.S. National Institutes of Health branch that helped fund the study, noted that "several hundred thousand Americans who are not taking AIDS drugs now, would be advised to start" a regimen of such treatment.
Zimbabwean government policy has been that only those with a CD4 cell count of 200 (compared with the norm around 800) are considered for ARVs state programs.
But the recommendation by HIV/AIDS professionals now is that even those with a CD4 "helper" cell count of 600 or 500 should be considered for treatment.
Complicating the matter, normal CD4 counts in individuals not infected with HIV range widely from 400 to 1,500 cells per cubic millimeter of blood.
The new guidelines pose a dilemma for Zimbabwean health authorities - adopting this as the new criterion for treatment would dramatically expand the group previously thought to need ARV drug therapy, estimated at something like 500,000 people.
Director Loice Chingandu of the Southern Africa AIDS Information Dissemination Service told reporter Carole Gombakomba of VOA's Studio 7 for Zimbabwe that with ARVs in short supply in Zimbabwe, the government may be reluctant to change policy.
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