Early uptake of HIV treatment has doubled in the UK
Early uptake of HIV treatment among people living with HIV in the UK has more than doubled over a five-year period between 2008 and 2011. The new figures were recently presented at a meeting held by Public Health England last week, and reported in Aidsmap.
The number of people who started treatment with a CD4 count of more than 350 cells/mm3 had increased from 24% is 2008, to 49% in 2011. The proportion of these people who had a CD4 count of above 500 cells/mm3 had increased from 8% to 27% over the same time period. In the UK, it is recommended that all people start treatment at a CD4 count of 350 cells/mm3, unless they have a comorbidity or are pregnant. However, the recommendations also state that doctors must speak with their patients about the benefit of early treatment for prevention, and if they wish to start treatment, they may. The numbers of people living with HIV in the UK who are on treatment rose from 75% to 86% between 2008 and 2011. The researchers remarked that this increase is most likely the result of an increased awareness of the benefits of treatment for prevention.
Looking closer at the demographics, people aged 25-34, white people, and men who have sex with men were the groups most likely to start treatment early. People who had been diagnosed late were four times more likely to not start treatment early, compared to those who had recently been infected. Of those who started treatment early, 90% achieved an undetectable viral load after one year. However, certain groups had lower adherence and did not achieve viral load suppression – these were young people aged 15-24 and 25-34, heterosexual men, people living in poorer areas and those who started treatment with a CD4 count of above 500 cells/mm3.
The presenters remarked that despite the guidelines not explicitly stating that people should start treatment early, many are doing so. Changing guidelines so that people must start treatment early would not have a significant public health impact, or on the real numbers of people starting treatment in the UK.