Establishing targets for advanced HIV disease: A call to action
Southern African Journal of HIV Medicine
| Field | Value | |
| Title | Establishing targets for advanced HIV disease: A call to action | |
| Creator | Meya, David B. Tugume, Lillian Nabitaka, Vennie Namuwenge, Proscovia Phiri, Sam Oladele, Rita Jibrin, Bilkisu Mobolaji-Bello, Mojisola Kanyama, Cecilia Maokola, Werner Mfinanga, Sayoki Katureebe, Cordelia Amamilo, Ikechukwu Ngwatu, Brian Jarvis, Joseph N. Harrison, Thomas S. Shroufi, Amir Rajasingham, Radha Boulware, David Govender, Nelesh P. Loyse, Angela | |
| Description | The World Health Organization (WHO) has published a guideline for the management of individuals with advanced HIV disease (AHD) to reduce HIV-related deaths. The guideline consists of a package of recommendations including interventions to prevent, diagnose and treat common opportunistic infections, including tuberculosis (TB), cryptococcosis and severe bacterial infections, along with rapid initiation of antiretroviral treatment and enhanced adherence support. Currently no clear targets exist for these key interventions. Emerging programmatic data from Uganda, Tanzania and Nigeria suggest that an estimated 80% of eligible people continue to miss the recommended cryptococcal or TB testing, highlighting the remaining challenges to the effective implementation of WHO-recommended AHD packages of care in real-world resource-limited settings. The absence of mortality indicators for the leading causes of HIV-related deaths, because of the lack of mechanisms to ascertain cause of death, has had a negative impact on establishing interventions to reduce mortality. We suggest that setting 95-95-95 targets for CD4 testing, cryptococcal antigen and TB testing, and treatment that are aligned to the WHO AHD package of care would be a step in the right direction to achieving the greater goal of the WHO End TB strategy and the proposed new strategy to end cryptococcal meningitis deaths. However, these targets will only be achieved if there is healthcare worker training, expanded access to bedside point-of-care diagnostics for hospitalised patients and those in outpatient care who meet the criteria for AHD, and health systems strengthening to minimise delays in initiating the WHO-recommended therapies for TB and cryptococcal disease. | |
| Publisher | AOSIS | |
| Date | 2021-08-10 | |
| Identifier | 10.4102/sajhivmed.v22i1.1266 | |
| Source | Southern African Journal of HIV Medicine; Vol 22, No 1 (2021); 5 pages 2078-6751 1608-9693 | |
| Language | eng | |
| Relation |
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:
https://sajhivmed.org.za/index.php/hivmed/article/view/1266/2499
https://sajhivmed.org.za/index.php/hivmed/article/view/1266/2500
https://sajhivmed.org.za/index.php/hivmed/article/view/1266/2501
https://sajhivmed.org.za/index.php/hivmed/article/view/1266/2502
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