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1. Treat Everyone Living with HIV


In September the World Health Organization released updated guidelines calling for antiretroviral therapy (ART) for everyone diagnosed with HIV regardless of CD4 T-cell count, as well as pre-exposure prophylaxis for people at substantial risk of infection. WHO estimates that the recommendations, if widely adopted, could avert 21 million deaths and prevent 28 million new infections worldwide by 2030.

The European AIDS Clinical Society (EACS) also recommended universal ART for all people with HIV at the European AIDS Conference in October, bringing major international guidelines into agreement about when to start treatment.

Universal treatment is supported by findings from the START study, first announced in May and presented in full at the International AIDS Society Conference (IAS 2015) in July. START participants with CD4 counts above 500 cells/mm3 were randomly assigned to either start treatment immediately or to delay therapy until their CD4s fell below 350 or they developed symptoms of AIDS. People in the immediate treatment group had a 57% lower risk of serious AIDS-related events, serious non-AIDS events, and death compared to the deferred therapy group.

Findings from the Temprano trial, presented at the Conference on Retroviruses and Opportunistic Infections (CROI) in February, likewise showed that starting HIV treatment at a CD4 count above 500 reduced the risk of serious illness and death compared to starting later, as recommended by older treatment guidelines.

"IAS 2015 will be remembered as the definitive moment when the world agreed that earlier initiation of treatment is the best way to preserve the health of people living with HIV and one of the best tools we have to slow HIV transmission to others," said conference co-chair Julio Montaner from the British Columbia Centre for Excellence in HIV/AIDS.

Next: 2. More Evidence Shows PrEP is Highly Effective