logo
Science Portal
Copyright © Médecins Sans Frontières
v2.1.5145.produseast1
About MSF Science Portal
About
Contact Us
Frequently Asked Questions (FAQs)
Privacy Policy
Terms of Use
Copyright © Médecins Sans Frontières
v2.1.5145.produseast1
Managing advanced HIV disease in a public health approach | Journal Article / Commentary | MSF Science Portal
Journal Article
|Commentary

Managing advanced HIV disease in a public health approach

Ford NP, Meintjes GA, Calmy A, Bygrave H, Migone C, Vitoria M, Penazzato M, Vojnov L, Doherty M, Asero P, Bologna R, Chakroun M, Chambal L, Chiller T, Conradie F, Eholie SP, Frigati L, Gibb D, Goemaere E, Govender NP, Grant AD, Kumarasamy N, Lalloo DG, Le T, Letang E, Mbori-Ngacha D, Mfinanga S, Nacher M, Ribakare M, Siegfried N, Sikwese K, Tun NL, Vidal JE
Download

Similar Content
Loading...
Loading...
Loading...
Abstract
In 2017, the World Health Organization (WHO) published guidelines for the management of advanced human immunodeficiency virus (HIV) disease within a public health approach. Recent data suggest that more than a third of people starting antiretroviral therapy (ART) do so with advanced HIV disease, and an increasing number of patients re-present to care at an advanced stage of HIV disease following a period of disengagement from care. These guidelines recommend a standardized package of care for adults, adolescents, and children, based on the leading causes of morbidity and mortality: tuberculosis, severe bacterial infections, cryptococcal meningitis, toxoplasmosis, and Pneumocystis jirovecii pneumonia. A package of targeted interventions to reduce mortality and morbidity was recommended, based on results of 2 recent randomized trials that both showed a mortality reduction associated with delivery of a simplified intervention package. Taking these results and existing recommendations into consideration, WHO recommends that a package of care be offered to those presenting with advanced HIV disease; depending on age and CD4 cell count, the package may include opportunistic infection screening and prophylaxis, including fluconazole preemptive therapy for those who are cryptococcal antigen positive and without evidence of meningitis. Rapid ART initiation and intensified adherence interventions should also be proposed to everyone presenting with advanced HIV disease.

Subject Area

models of careHIV/AIDS

Languages

English
DOI
10.1093/cid/cix1139
Published Date
04 Mar 2018
PubMed ID
29514232
Journal
Clinical Infectious Diseases
Volume | Issue | Pages
Volume 66, Issue suppl_2, Pages S106-SS110
Issue Date
2018-03-04
Dimensions Badge