The World Health Organisation (WHO) has recommended that the most widely used HIV anti-retroviral treatment be phased out (Reuters, BBC).
The advice to phase out the use of stavudine comes as part of the WHO’s revamped advice for treating HIV on the eve of World AIDS day (press release). That advice includes starting anti-retroviral sooner in adults and adolescents, and for the first time WHO recommends that HIV-positive breast-feeding mothers take anti-retrovirals to try and stop infants being infected.
Mothers infected with HIV are also now recommended to begin taking anti-retrovirals earlier in their pregnancy (previously it was recommended that HIV-positive mothers started taking the drugs in their third trimester to stop the infection being transmitted to the child). The new recommendations say that the anti-retrovirals should be taken from the 14th week and until the end of the breast feeding period. “We are sending a clear message that breastfeeding is a good option for every baby, even those with HIV-positive mothers, when they have access to ARVs," says Daisy Mafubelu, WHO’s Assistant Director General for Family and Community Health.
The recommendation that stavudine be phased out was made because of long term and irreversible side effects that the drug causes, including wasting and neurological problems. Other drugs exist that do the same job without side effects, and in the developed world stavudine is not widely used. But it’s cheap and widely available, making it more popular in developing countries.
The recommendations will lead to more people needing treatment, says the WHO, but justifies this saying: “The associated costs of earlier treatment may be offset by decreased hospital costs, increased productivity due to fewer sick days, fewer children orphaned by AIDS and a drop in HIV infections.”
According to WHO, 33.4 million people are living with HIV/AIDS, with 2.7 million new infections each year. Globally, HIV/AIDS is the leading cause of death for women of reproductive age.
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