WHO Updates HIV Treatment Recommendations

Almost simultaneously, the WHO and the U.S. Department of Health and Human Services (DHHS) released updated guidelines for HIV treatment. Both raised the CD4-cell–count threshold for starting treatment, and both refined their preferences for first-line regimens. The new WHO recommendations, outlined below, were published online in three rapid-advice documents, with the full set of guidelines expected in February 2010. (A complete review of the DHHS guidelines, by Dr. Abigail Zuger, is available here.)

• All adolescents and adults with HIV infection and CD4 counts ≤350 cells/mm³, including pregnant women, should be started on antiretroviral therapy (ART) immediately, regardless of whether they have clinical symptoms. (The previous set of guidel…