WHO Recommends Continued Antiretroviral Treatment for HIV+ Women after Delivery


The World Health Organization (WHO) this month published new guidance recommending that women with HIV who receive combination antiretroviral therapy (ART) during pregnancy for prevention of mother-to-child transmission should remain on ART on an ongoing basis, regardless of CD4 T-cell count.

The new report comes amid growing evidence -- such as findings from the HPTN 052 trial -- showing that effective ART dramatically reduced the risk of HIV transmission to sexual partners.

Although global guidelines for low-income countries recommend starting ART when a person's CD4 count falls below 350 cells/mm3, the latest U.S. guidelines released this month advise that everyone diagnosed with HIV should consider treatment.

According to the WHO report, continuing to treat HIV positive women after delivery with a triple-combination regimen -- referred to as Option B+ -- streamlines public health efforts as all women with HIV would be treated the same, whether they are receiving ART for their own health or to prevent transmission to their babies.

Staying on ART after delivery has the added advantages of protection against mother-to-child transmission in future pregnancies, continued prevention benefit against sexual transmission to serodiscordant partners, and avoidance of stopping and starting antiretroviral drugs, which can promote development of resistance if not done correctly.

The executive summary of the WHO Programmatic Update on Use of Antiretroviral Drugs for Treating Pregnant Women and Preventing HIV Infection in Infants is available online at http://www.who.int/hiv/PMTCT_update.pdf.



WHO HIV/AIDS Programme. Programmatic Update: Use of Antiretroviral Drugs for Treating Pregnant Women and Preventing HIV Infection. Executive summary. April 2012.