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Guideline: Updates on HIV and infant feeding. The duration of breastfeeding and support from health services to improve feeding practices among mothers living with HIV.
Geneva, Switzerland, WHO, 2016.  p.The objective of this guideline is to improve the HIV-free survival of HIV-exposed infants by providing guidance on appropriate infant feeding practices and use of ARV drugs for mothers living with HIV and by updating WHO-related tools and training materials. The guideline is intended mainly for countries with high HIV prevalence and settings in which diarrhoea, pneumonia and undernutrition are common causes of infant and child mortality. However, it may also be relevant to settings with a low prevalence of HIV depending on the background rates and causes of infant and child mortality. This guideline aims to help Member States and their partners in their efforts to make informed decisions on the appropriate nutrition actions to achieve the Sustainable Development Goals, the global targets set in the comprehensive implementation plan on maternal, infant and young child nutrition, the Global Strategy for Women’s, Children’s and Adolescents’ Health (2016-2030) and the Global Health Sector Strategy on Sexually Transmitted Infections 2016-2021. The target audience for this guideline includes: (1) national policy-makers in health ministries; (2) programme managers working in child health, essential drugs and health worker training; (3) health-care providers, researchers and clinicians providing services to pregnant women and mothers living with HIV at various levels of health care; and (4) development partners providing financial and/or technical support for child health programmes, including those in conflict and emergency settings. (Excerpt)
Geneva, Switzerland, WHO, 2015 Sep.  p. (Guidelines)This early-release guideline makes available two key recommendations that were developed during the revision process in 2015. First, antiretroviral therapy (ART) should be initiated in everyone living with HIV at any CD4 cell count. Second, the use of daily oral pre-exposure prophylaxis (PrEP) is recommended as a prevention choice for people at substantial risk of HIV infection as part of combination prevention approaches. The first of these recommendations is based on evidence from clinical trials and observational studies released since 2013 showing that earlier use of ART results in better clinical outcomes for people living with HIV compared with delayed treatment. The second recommendation is based on clinical trial results confirming the efficacy of the ARV drug tenofovir for use as PrEP to prevent people from acquiring HIV in a wide variety of settings and populations. The recommendations in this guideline will form part of the revised consolidated guidelines on the use of ARV drugs for treating and preventing HIV infection to be published by WHO in 2016. The full update of the guidelines will consist of comprehensive clinical recommendations together with revised operational and service delivery guidance to support implementation.
Expert Opinion On Pharmacotherapy. 2009 Aug; 10(11):1783-91.BACKGROUND: Treating HIV-infected children remains a challenge due to a lack of treatment options, appropriate drug formulations and, in countries with limited resources, insufficient access to diagnostic tests and treatment. OBJECTIVE: To summarize current data concerning new opportunities to improve the treatment of HIV-infected children. METHODS: This review includes data from the most recently published peer-reviewed publications, guidelines or presentations at international meetings concerning new ways to treat HIV-infected children. RESULTS/CONCLUSIONS: New WHO guidelines recommend starting combination antiretroviral treatment in all infants aged < 1 year. Although this is common practice in some high-income countries, implementation of these recommendations in countries with limited resources is still a challenge. There is still an important gap between the availability of licensed drugs in children compared with adults. There remains a need for further pharmacokinetic studies, and for more pediatric formulations of antiretroviral drugs with improved palatability.
High prevalence of antiretroviral drug resistance mutations in HIV-1 non-B subtype strains from African children receiving antiretroviral therapy regimen according to the 2006 revised WHO recommendations [letter]
Journal of Acquired Immune Deficiency Syndromes. 2008 Dec 15; 49(5):566-9.Add to my documents.
HIV and AIDS treatment education: a critical component of efforts to ensure universal access to prevention, treatment and care. UNAIDS Inter-Agency Task Team (IATT) on Education.
Paris, France, UNESCO, 2006 Jun. 50 p. (ED.2006/WS/11309713)This paper explores some of the issues contained within the definition of treatment education, signalling ways that the education sector can play a role along with others engaged in treatment access and education. It considers some key strategies, including how to effectively engage and prepare communities and how to involve key constituencies, particularly people with HIV and those on treatment. Moreover, the paper reexamines the harmful effects of stigma and discrimination and how these impede progress in prevention as well as expanded treatment access. The paper also suggests some possible future directions, underscoring areas of particular priority. These include the need for: Identification, documentation and wide dissemination of effective approaches to treatment education that are feasible, sustainable and that can be scaled up; Development of practical guidelines and materials that can be used by programme implementers to support the integration of treatment education within ongoing HIV and AIDS education efforts; Ongoing and close communication with authorities and organizations responsible for expanding treatment access to ensure coherent and well-coordinated programming. (excerpt)
Geneva, Switzerland, WHO, 2005.  p. (WHO/HTM/TB/2005.349)The goal of this series of annual reports is to chart progress in global TB control and, in particular, to evaluate progress in implementing the DOTS strategy. The first targets set for global TB control were ratified in 1991 by WHO’s World Health Assembly. They are to detect 70% of new smearpositive TB cases, and to successfully treat 85% of these cases. Since these targets were not reached by the end of year 2000 as originally planned, the target year was deferred to 2005.4 In 2000, the United Nations created a new framework for monitoring progress in human development, the MDGs. Among 18 MDG targets, the eighth is to “have halted by 2015 and begun to reverse the incidence of malaria and other major diseases”. Although the objective is expressed in terms of incidence, the MDGs also specify that progress should be measured in terms of the reduction in TB prevalence and deaths. The target for these two indicators, based on a resolution passed at the 2000 Okinawa (Japan) summit of G8 industrialized nations, and now adopted by the Stop TB Partnership, is to halve TB prevalence and death rates (all forms of TB) between 1990 and 2015. All three measures of impact (incidence, prevalence and death rates) have been added to the two traditional measures of DOTS implementation (case detection and treatment success), so that the MDG framework includes five principal indicators of progress in TB control. All five MDG indicators will, from now on, be evaluated by WHO’s Global TB Surveillance, Planning and Financing Project. The focus is on the performance of NTPs in 22 HBCs, and in priority countries in WHO’s six regions. (excerpt)
Geneva, Switzerland, WHO, Department of HIV / AIDS, .  p.Adherence, “the extent to which a person’s behavior – taking medication, following a diet, and/or executing lifestyle changes, corresponds with agreed recommendations from a health care provider”, is a crucial element for the implementation of the HIV treatment scale-up initiative. Properly taken, HAART (highly active anti-retroviral therapy) has been shown to reduce viral loads, but the requirements for adherence are high – most studies suggest that it has to be higher than 90% to avoid the risk of resistance. (excerpt)
Antiretroviral therapy in primary health care: experience of the Khayelitsha programme in South Africa. Case study.
Geneva, Switzerland, WHO, 2003. 10 p. (Perspectives and Practices in Antiretroviral Treatment)With 42 million people now living with HIV/AIDS, expanding access to antiretroviral treatment for those who urgently need it is one of the most pressing challenges in international health. Providing treatment is essential to alleviate suffering and to mitigate the devastating impact of the epidemic. It also presents unprecedented opportunities for a more effective response by involving people living with HIV/AIDS, their families and communities in care and will strengthen HIV prevention by increasing awareness, creating a demand for testing and counselling and reducing stigma and discrimination. The challenges are great. Sustainable financing is essential. Drug procurement and regulatory mechanisms must be established. Health care workers must be trained, infrastructure improved, communities educated and diverse stakeholders mobilized to play their part. This series, Perspectives and Practice in Antiretroviral Treatment, provides examples of how such challenges are being overcome in the growing number of developing countries in which antiretroviral treatment programmes are underway. The case studies and analyses in this series show how governments, civil society organizations, private corporations and others are successfully providing antiretroviral treatment and care to people with HIV/AIDS, even in the most resource-constrained settings. In documenting these pioneering programmes, WHO hopes that their experiences will both inform and inspire everyone who is working to make access to treatment a reality. (excerpt)
Scaling up antiretroviral therapy in resource-limited settings: treatment guidelines for a public health approach. Rev. ed.
Geneva, Switzerland, WHO, 2003. 67 p.Currently, fewer than 5% of people in developing countries who need ART can access the medicines in question. WHO believes that at least 3 million people needing care should be able to get the medicines by 2005. This represents almost a tenfold increase. These treatment guidelines are intended to support and facilitate the proper management and scale-up of ART in the years to come by proposing a public health approach to achieve the goals. The key tenets of this approach are as follows. 1) Scaling-up of antiretroviral treatment programmes with a view to universal access, i.e. all persons requiring treatment as indicated by medical criteria should have access to it. 2) Standardization and simplification of ARV regimens so as to support the efficient implementation of treatment programmes in resource-limited settings. 3) Ensuring that ARV treatment programmes are based on scientific evidence in order to avoid the use of substandard protocols that compromise the outcomes of individual patients and create a potential for the emergence of drug-resistant virus. However, it is also important to consider the realities with respect to the availability of human resources, health system infrastructures and socioeconomic contexts so that clear and realistic recommendations can be made. (excerpt)