The dangers of delaying ART treatment
South Africa’s approach, as outlined by the Department of Health, has been to only start ARVs once a person’s count has slipped to below 350 cells/mm3. (The CD4 cell count indicates the state of an individual’s immune system and in an average HIV- male could be anywhere between 400 and 1600.)
While South Africa’s low starting point is already below the suggested minimum, the WHO’s recommended guidelines tended to focus, at the time, on curbing the transmission of the virus (those who started ARVs at higher CD4 counts were about 96% less likely to transmit the virus). The latest study contemplates the quality of life of those already infected, with the emphasis on decreasing the prospect of serious illness – a major concern considering the cost and impact of HIV-related illnesses.
Although there may be differences of opinion with respect to when to start ART, there is agreement the world over on the matter of strict adherence once on treatment. We at AllLife strongly encourage the belief that “adherence to proper monitoring and treatment is still the only proven way to maintain optimal health for people living with HIV”.
As a specialised insurance provider, AllLife offers life and disability cover to HIV+ people. A key requirement for the Advantage Life or Advantage Life Disability policy is a commitment to adhere to a specific protocol. This essentially means that the antiretroviral drugs need to be taken at precisely the same time every day in the exact way prescribed. Policyholders are then required to submit CD4 and Viral Load test results at least once every six months in order to demonstrate their compliance. Our clients commitment to our Adherence program can statistically substantiate our claims to have seen “a major improvement in our clients’ CD4+ count of approximately 15% within 6 months of taking out life insurance cover” with us, which can be attributed to the AllLife Adherence programme requirements and monthly health tips and daily social media advice.. This evidence further supports the importance of ART and the corresponding significance of adherence.
The results of the Temprano study were presented at the Conference on Retroviruses and Opportunistic Infections in February 2015 and are expected to be considered in a review of the optimal timing to start ART. The WHO is expected to release their updated recommendations at the end of this year.