IAS 2017: Expanded treatment guidelines expand access to many without harms to those already in care in Zambia

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Science Speaks is in Paris this week covering the 9th IAS Conference on HIV Science.

PARIS – Expanding treatment eligibility under new treatment guidelines in Zambia led to increases in initiation, retention and the percentage of people in care without negative effects on those already in care, a presenter from CIDRZ, the Centre for Infectious Disease Research in Zambia, said today.

Aaloke Mody was presenting the findings from a study analyzing the impacts of the April 2014 expansion of treatment eligibility that took the requirement to start having an immune cell, or CD4 count diminished to 350 per milliter of blood to 500. The study looked at both uptake of antiretroviral treatment and possible unintended, and negative consequences to patients already in care in 64 CIDRZ clinics in Zambia.  CIDRZ researchers found a 15.5 percent increase in newly eligible patients initiating HIV treatment within three months of the guideline change with no impact on treatment initiation and retention for those with lower CD4 counts who were already eligible for treatment.

The median CD4 count of those newly enrolled in treatment during this period was 267, with 70 percent of those enrolling in late stages of HIV disease.

“Efforts are still needed to increase early diagnosis and linkage to care,” said Mody, but noted that the study suggests that “treat all will not crowd out sick patients.”

Zambia adopted a universal treatment policy in December 2016.

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