E-Forum questions for Civil Society Consultation: 2013 WHO Consolidated ART Guidelines

WEEK 1 Adults and Adolescents – ARV Clinical guidelines 1st sub-topic : When to initiate ARV treatment (clinical thresholds) and what form should treatment be given Background: Clinical thresholds to initiate ART Currently WHO recommends that adolescents and adults (including pregnant women) start ART when the CD4 count is 350 or less. WHO also recommends that adolescents and adults regardless of CD4 count start treatment if they have Stage III/IV disease (such as those who have ever had tuberculosis), children living with HIV below 2 years of age, pregnant women living with HIV and people living with HIV who are or who could become sexually active with HIV negative people (we will be going into more detail on treatment as prevention later on this week). There is also some evidence that earlier access to treatment (above CD4 350) for a wider group of people living with HIV could ensure more people start ART earlier, improve their own health, and reduce rates of HIV transmission. We would like to hear the community and civil society views on whether the recommendation on the CD4 level threshold for initiating ART should change (e.g., from