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[HATIP #19], 4 December 2003
A regular electronic newsletter for health care workers and community-based organisations on HIV treatment in resource-limited settings. It is supported by and produced in collaboration with St Stephen's AIDS Trust and the International HIV/AIDS Alliance.

Its publication is also supported by Positive Action of GlaxoSmithKline, Boehringer Ingelheim and the Access 4 Trust.
   Last updated: 19.10.05
WHO announces 3 x 5 plans
WHO unveils plans to treat 3 million by 2005

  • The World Health Organisation has published details of its plan to bring antiretroviral treatment to 3 million people living with HIV by the end of 2005.


http://www.aidsmap.com/news/newsdisplay2.asp?newsId=2447

  • International experts have agreed that a triple combination of d4T (stavudine), 3TC (lamivudine) and nevirapine is likely to be the best option for swift implementation of antiretroviral treatment in resource-limited settings. The recommendation was agreed at a WHO and UNAIDS-sponsored consultation in Zambia in mid-November, and follows a similar recommendation from a consensus meeting sponsored by Medecins sans Frontieres in September.


Community mobilisation key to success of 3 x 5

  • The WHO 3 x 5 plan envisages that community-based organisations, including groups of people living with HIV, will play a key role in scaling up treatment. This is not just a measure to plug gaps in the health services of heavily affected countries, but a response to evidence from early pilot programmes. These programmes have demonstrated that community participation is a key element in ensuring the acceptability of treatment. Making treatment part of the social fabric rather than a hidden enterprise is the only way to ensure long-term adherence.


News links from aidsmap.com
A selection of news stories which have appeared since November 24th 2003.

India to begin free HIV treatment programme, will treat 100,000 within a year

  • The Indian government will provide free antiretroviral treatment through government hospitals starting from April 2004, Health Minister Sushma Swaraj announced today. The Indian government plans to provide treatment for 100,000 people in the first year, at a cost of 2 billion rupees (US$40 million).


Treatment with HAART reduces liver-related mortality in HIV/HCV coinfected patients

  • Treatment with HAART is associated with a lower rate of mortality from liver-related causes in individuals coinfected with HIV and hepatitis C virus (HCV), according to a German study published in the November 22nd edition of The Lancet.



HIV testing in Africa: will VCT for all do more than ABC approach?

  • Two contrasting viewpoints on voluntary testing and counselling for HIV in developing countries are put forward this week in The Lancet. Whilst Dr Kevin De Cock of the US Centers for Disease Control in Kenya argues that universal voluntary counselling and HIV testing (VCT) is the only way to get a grip on the epidemic in sub-Saharan Africa, Dr Jeffrey Stringer of the Centre for Infectious Disease Research in Zambia suggests that in the short term, VCT cannot be implemented on the scale needed to meet one of the most ambitious United Nations goals – the reduction of mother to child HIV transmission by 20% by 2005 and by 50% by 2010. Instead, he argues, nevirapine treatment should be universally deployed for all women giving birth in high prevalence areas.


Gastrointestinal side-effects lead one in eight to change HAART regimen in first year of treatment

  • Over 50% of patients taking anti-HIV treatments for the first time will change or stop taking their drugs in the first year of therapy, often due to side-effects, and in many instances without telling their doctor first, according to US research published in the November 21st edition of the Journal of Acquired Immune Deficiency Syndromes. Investigators also found that gastrointestinal side-effects such as nausea, vomiting, and diarrhoea were the side-effects most often associated with a need to change treatment, accounting for 12.5% of all treatment changes.


HAART can be safely delayed until CD4 cell count falls to 200, provided individuals are adherent

  • HIV-positive individuals can safely delay initiating HAART until their CD4 cell count falls to 200 cells/mm3 - provided they are adherent to their therapy, according to a Canadian study published in the November 18th edition of the Annals of Internal Medicine. The Canadian investigators also found that provided a patient is adherent to their therapy, individuals who started anti-HIV treatments when their CD4 cell count was 200 cells/mm3 were just as likely to survive as those who initiated HAART with a CD4 cell count of 350 cells/mm3 or above.



UNAIDS: Injecting drug use fuelling exploding HIV epidemics

  • Injecting drug use (IDU) remains a significant HIV transmission factor in many regions of the world, driving fast-growing epidemics in Eastern Europe & Central Asia, Asia & the Pacific, Latin America and North Africa. For example, the HIV epidemic among adults in Libya has been driven by IDU, with 90% of all known HIV infections to date occurring among IDUs. Additionally, close to 25% of new HIV infections in the US and Canada last year were due to IDU, and in Portugal this mode of transmission was responsible for almost half of all HIV infections in 2002.


UNAIDS: HIV prevalence surges to 1.5m in Eastern Europe and Central Asia

  • The number of people estimated to be living with HIV rose by 230,000 in Eastern Europe and Central Asia in 2003, from 1.27 million in 2002 to 1.5 million by the end of 2003, according to figures released today by UNAIDS ahead of World AIDS Day on December 1st.



UNAIDS: HIV prevalence increases 10% in South America and Caribbean

  • The UNAIDS report on the HIV epidemic in South America and the Caribbean describes a region which witnessed a 10% increase in total HIV prevalence in the past year, and where prejudice means that resources are often not directed to the communities most in need of HIV prevention.



UNAIDS: Gay men still the group most affected by HIV in many rich countries

  • HIV continues to spread amongst gay men in richer countries, according to the UNAIDS annual update on the world AIDS epidemic published today. The report highlighted that in several European countries, as well as Australia gay men still accounted for the majority of new infections. Resurgent epidemics of sexually transmitted infections (STIs), particularly syphilis, suggesting to UNAIDS an increase in risky sexual behaviour amongst gay men.


UNAIDS says one in five adults now HIV-positive in southern Africa

  • Globally, five million people became infected with HIV in 2003, the worst year so far in the burgeoning epidemic. Of these, 700,000 are children under the age of 15. The majority of these infections occurred in sub-Saharan Africa.


Growing political momentum behind war on AIDS

  • Britain will put AIDS at the centre of of its presidency of the G8 group of rich nations and the European Union in 2005, said Hilary Benn, UK Secretary of State for International Development, with a call for action due to be launched on December 1st that will urge more political commitment, more investment in prevention and treatment, better coordination of donors and better delivery of services on the ground.




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