In 2002, the World Health Organization (WHO) first published guidelines for a public health approach to scaling up antiretroviral therapy (ART) in resource-limited settings. These guidelines were simplified in 2003 and revised in 2006. Throughout 2009, WHO engaged with multiple stakeholders to update HIV treatment guidelines, culminating in the dissemination of Rapid Advice: Antiretroviral Therapy for HIV Infection in Adults and Adolescents in late November 2009 (WHO 2009b). Table 1 lists eight key Rapid Advice recommendations. The full revised guidelines, Antiretroviral Therapy for HIV Infection in Adults and Adolescents: Recommendations for a Public Health Approach (July 2010 version), expanded on Rapid Advice and were released in July 2010 (WHO 2010a).
The key messages that emerged from these recommendations were earlier initiation of ART, the use of less toxic treatment regimens, and an expanded role for laboratory monitoring, including both CD4 testing and viral load (VL) monitoring (WHO 2010a).
Although the scientific evidence in support of these recommendations is compelling, national programs in resource-limited settings throughout the world are encountering challenges with their adoption and implementation. The aim of this technical brief is to provide policymakers and program managers with a point of reference as they adapt and implement revised national treatment guidelines. JSI/AIDSTAR-One. 2012.
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