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Maharashtra ignores WHO guideline

Despite World Health Organisation’s (WHO) new guideline to provide antiretroviral therapy for everyone diagnosed with HIV regardless of CD4 cell count, state ART centers are ignoring it, a move that c

Despite World Health Organisation’s (WHO) new guideline to provide antiretroviral therapy for everyone diagnosed with HIV regardless of CD4 cell count, state ART centers are ignoring it, a move that can lead to more deaths.

Anita Mehta, 32-year-old, resident of Thane succumbed to HIV infection last month after struggling for a year. She would have survived for a few more years had she started the treatment at an earlier stage. Like her, hundreds of HIV-infected patients die due to delay in treatment. To address this issue, WHO had on October 1, released a new guideline calling for universal antiretroviral treatment to all patients irrespective of the CD4 counts.

In a press conference, Gottfried Hirnschall, director of WHO’s department of HIV/AIDS had reportedly said, “These new recommendations will have tremendous impact on peoples’ lives, if rapidly implemented. So we must work together to support countries to translate them into action and results.”

However, ART centres in Maharashtra are yet to implement the new guideline, as National Aids Control Organisation (NACO) has not given them the nod yet. “We follow NACO’s guideline so until they give us the go-ahead sign, we can’t provide universal treatment to patients irrespective of their CD4 count. So far, we have not received any notice from the government,” said Dr Srikala Acharya, director of Maharashtra AIDS Control Society (MDACS).

Currently, as per the old NACO’s guideline, an HIV patient is given free treatment at ART centres only with CD4 count below 350. However, experts opine that this new guideline will help in decreasing the mortality rate of patients with HIV. “However, NACO has made two exceptions in their guidelines — HIV patients with tuberculosis or pregnant are given treatment without considering the CD4 count,” said Dr Acharya. “If this guideline is implemented, it will be extremely fruitful for patients. But we are no one to comment on the matter as the power lies with Centre to act on the guideline,” she added.

“It is essential for HIV patients to start the treatment at the earliest. It increases the chances of having longer life. Also, early treatment might also improve their health by increasing their immunity system,” said Dr Udaykumar Jadhav, HIV expert from the state.

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