* New guidelines recommend earlier treatment with AIDS drugs

* Some 34 million people worldwide are HIV positive

* Guidelines mean 26 million people should get treatment

* AIDS drugs can keep people healthy and stop HIV spreading

By Kate Kelland

LONDON, June 30 (Reuters) - Doctors could save three million more lives worldwide by 2025 if they offer AIDS drugs to people with HIV much sooner after they test positive for the virus, the World Health Organisation said on Sunday.

While better access to cheap generic AIDS drugs means many more people are now getting treatment, health workers, particularly in poor countries with limited health budgets, currently tend to wait until the infection has progressed.

But in new guidelines aimed at controlling and eventually reducing the global AIDS epidemic, the U.N. health agency said some 26 million HIV-positive people - or around 80 percent of all those with the virus - should be getting drug treatment.

The guidelines, which set a global standard for when people with human immunodeficiency virus (HIV) should start antiretroviral treatment, were drawn up after numerous studies found that treating HIV patients earlier can keep them healthy for many years and also lowers the amount of virus in the blood, significantly cutting their risk of infecting someone else.

"We are raising the bar to 26 million people," said Gottfried Hirnschall, the WHO's HIV/AIDS department director.

"And this is not only about keeping people healthy and alive but also about blocking further transmission of HIV."

Some 34 million people worldwide have the HIV virus that causes AIDS and the vast majority of them live in poor and developing countries. Sub-Saharan Africa is by far the worst affected region.

But the epidemic - which has killed 25 million people in the 30 years since HIV was first discovered - is showing some signs of being turned around. The United Nations AIDS programme UNAIDS says deaths from the disease fell to 1.7 million in 2011, down from a peak of 2.3 million in 2005 and from 1.8 million in 2010.

Swift progress has also been made in getting more HIV patients into treatment, with 9.7 million people getting life-saving AIDS drugs in 2012, up from just 300,000 people a decade earlier, according to latest WHO data also published on Sunday.

Indian generics companies are leading suppliers of HIV drugs to Africa and to many other poor countries. Major Western HIV drugmakers include Gilead Sciences, Johnson & Johnson and ViiV Healthcare, which is majority-owned by GlaxoSmithKline.


"IRREVERSIBLE DECLINE"?

Margaret Chan, the WHO's director general, said the dramatic improvement in access to HIV treatment raised the prospect of the world one day being able to beat the disease.

"With nearly 10 million people now on antiretroviral therapy, we see that such prospects - unthinkable just a few years ago - can now fuel the momentum needed to push the HIV epidemic into irreversible decline," she said in a statement.

The WHO's guidelines encourage health authorities worldwide to start treatment in adults with HIV as soon as a key test known as a CD4 cell count falls to a measure of 500 cells per cubic millimetre or less.

The previous WHO standard was to offer treatment at a CD4 count of 350 or less, in other words when the virus has already started to damage the patient's immune system.

The guidelines also say all pregnant or breastfeeding women and all children under five with HIV should start treatment immediately, whatever their CD4 count, and that all HIV patients should be regularly monitored to assess their "viral load".

This allows health workers to check whether the medicines are reducing the amount of virus in the blood. It also encourages patients to keep taking their medicine because they can see it having positive results.

"There's no greater motivating factor for people to stick to their HIV treatment than knowing the virus is 'undetectable' in their blood," said Gilles van Cutsem, the medical coordinator in South Africa for the international medical humanitarian organisation Médecins Sans Frontières (MSF).

MSF welcomed the new guidelines but cautioned that the money and the political will to implement them was also needed.

"Now is not the time to be daunted but to push forward," MSF president Unni Karunakara said in a statement. "So it's critical to mobilise international support... including funding for HIV treatment programmes from donor governments."

The WHO's Hirnschall said getting AIDS drugs to the extra patients brought in by the new guidelines would require another 10 percent on top of the $22-$24 billion a year currently needed to fund the global fight against HIV and AIDS. (Editing by Gareth Jones)

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  • 1. Most Don't Have Their Infection Under Control

    Only one quarter of the 1.1 million <a href="http://www.cdc.gov/nchhstp/newsroom/docs/2012/Stages-of-CareFactSheet-508.pdf">people with HIV</a> have their <a href="http://www.huffingtonpost.com/2012/07/27/hiv-under-control-1-in-4_n_1711260.html">condition under control</a>, where "under control" means the virus has been suppressed, according to a report released this summer by the Centers for Disease Control and Prevention. "Only if we get <a href="http://www.philly.com/philly/health/HealthDay667108_20120727_Only_1_in_4_Americans_With_HIV_Has_Virus_Under_Control__CDC.html">everyone under regular care</a> for HIV/AIDS can we recognize the full benefits of treatment and prevention," Irene Hall, an epidemiologist at the CDC and one of the authors of the report, told HealthDay. <em><strong>CORRECTION</strong>: The first sentence has been reworded to more accurately reflect the number of people with HIV.</em>

  • 2. Bone Marrow Transplants Could Play A Part In Being HIV-Free

    Two men with HIV and cancer no longer have <a href="http://www.huffingtonpost.com/2012/07/26/hiv-free-men-bone-marrow-transplants_n_1707505.html">detectable blood levels of the virus</a> after receiving bone marrow transplants for their cancers, news outlets reported this year. Doctors were unable to <a href="http://www.huffingtonpost.com/2012/07/26/hiv-free-men-bone-marrow-transplants_n_1707505.html">find any traces of HIV</a> in the men's cells after they received the bone marrow transplants while also being treated with antiretrovirals. The finding "suggests that under the <a href="http://abcnews.go.com/blogs/health/2012/07/26/two-more-patients-hiv-free-after-bone-marrow-transplants/">cover of anti-retroviral therapy</a>, the cells that repopulated the patient's immune system appear to be protected from becoming re-infected with HIV," Dr. Timothy Henrich, of Brigham and Women's Hospital, told ABC News. However, the Boston Globe pointed out that it's still too soon to say that these men have been<a href="http://www.huffingtonpost.com/2012/07/26/hiv-free-men-bone-marrow-transplants_n_1707505.html"> full-on <em>cured</em></a> of HIV, since they are still on the anti-retrovirals. There's no firm word on whether they will go off of the medication.

  • 3. No-Cost HIV Treatment Could Cut New Infection Rates

    New <a href="http://www.huffingtonpost.ca/2012/11/27/free-hiv-drugs-decrease-infection-bc_n_2200393.html">HIV infection rates</a> can be dramatically lowered by making antiretroviral drugs free, a study from Canadian researchers found. The Canadian Press reported on the study, conducted by B.C. Centre for Excellence in HIV-AIDS researchers, which showed that British Columbia -- a province that offers <a href="http://www.huffingtonpost.ca/2012/11/27/free-hiv-drugs-decrease-infection-bc_n_2200393.html">free access to antiretroviral therapy</a> -- had the lowest rate of new HIV infections over a more-than-10-year period, compared with Ontairio and Quebec.

  • 4. Many Young People Don't Know Their HIV Status

    More than half of HIV-infected young people are <a href="http://www.huffingtonpost.com/2012/11/27/hiv-youths-infected-aids-young-people_n_2198629.html">unaware that they have the virus</a>, according to a Centers for Disease Control and Prevention report. "Given everything we know about HIV and how to prevent it in 30 years of fighting the disease, it's just unacceptable that young people are <a href="http://www.huffingtonpost.com/2012/11/27/hiv-youths-infected-aids-young-people_n_2198629.html">becoming infected at such high rates</a>," Reuters reported CDC Director Dr. Thomas Frieden saying. The report also showed that for young people, 72 percent of the new HIV infections were in men who have sex with men, while almost 50 percent were in young, African-American males, Reuters reported. These figures are based on 2010 data.

  • 5. More People Are Living With HIV Than 10 Years Ago

    The number of people <a href="http://www.huffingtonpost.com/2012/07/18/hiv-aids-numbers-statistics-worldwide_n_1682936.html">living with HIV</a> has increased by 18 percent from 2001 to 2011, according to a report released this year from the United Nations Programme on AIDS. An estimated 34.2 million people around the world are living with HIV. The report also showed that <a href="http://www.huffingtonpost.com/2012/07/18/hiv-aids-numbers-statistics-worldwide_n_1682936.html">deaths from AIDS </a>have <em>dropped</em>, from 2.3 million in 2005-2006 to 1.7 million in 2011, Reuters reported.

  • 6. The Cost Of HIV Drugs Is Decreasing

    According to the same United Nations report, costs for the cheapest UN-recommended <a href="http://www.huffingtonpost.com/2012/07/18/hiv-aids-numbers-statistics-worldwide_n_1682936.html">antiretroviral therapy drugs</a> have also decreased over the past 10 years, Reuters reported. A year's worth of the drugs used to cost $10,000 in 2000 for one person; now, it costs $100 a year.

  • 7. HIV Treatment Truvada Can Also Be Used As A Preventive Measure

    The Food and Drug Administration this year officially approved the <a href="http://www.huffingtonpost.com/2012/08/09/truvada-heterosexuals-aids-hiv-prevention-pill_n_1760542.html">drug Truvada</a> -- which has been used since 2004 as a treatment for HIV -- to be sold as a preventive measure for people who don't have the infection, but are at high risk for it. The FDA said that the pill should be considered for <a href="http://www.huffingtonpost.com/2012/08/09/truvada-heterosexuals-aids-hiv-prevention-pill_n_1760542.html">preventive use</a> not only by gay or bisexual men who are at high risk for HIV, but also heterosexual men and women who may also face HIV risks, the Associated Press reported. <a href="http://www.huffingtonpost.com/2012/08/09/truvada-heterosexuals-aids-hiv-prevention-pill_n_1760542.html">Heterosexual men and women</a> make up more than one-fourth of new cases of HIV, and "that's not a portion of the epidemic we want to ignore," the CDC's Dr. Dawn Smith, who was the lead author of the new recommendations, told the Associated Press. The FDA also approved a new drug this year, <a href="http://www.huffingtonpost.com/2012/08/27/stribild-hiv-treatment-fda_n_1834734.html">Stribild</a>, to treat HIV, Reuters reported.

  • 8. Engineered Stem Cells Could Play A Part In Fighting HIV

    In findings published this year in the journal <em>PLoS Pathogens</em>, scientists from the University of California, Los Angeles found that it's possible to <a href="http://www.huffingtonpost.com/2012/04/16/stem-cell-aids-hiv-study-ucla_n_1428660.html">genetically engineer stem cells</a> to attack living HIV-infected cells in mice. While the study was only for "proof-of-principle," it "lays the groundwork for the potential use of this type of an approach in combating HIV infection in infected individuals, in hopes of eradicating the virus from the body," study researcher Dr. Scott G. Kitchen, an assistant professor of medicine at UCLA, said in a statement.

  • 9. Pretty Much Everyone Should Be Screened For HIV

    People should be screened for HIV even if they're not at high risk of contracting the infection, according to draft recommendations released just last month by the U.S. Preventive Services Task Force. The recommendations would mean that everyone between the ages of 15 and 65 should be <a href="http://www.huffingtonpost.com/2012/11/19/routine-hiv-screening-us-preventive-services-task-force-uspstf_n_2161090.html">screened for HIV</a>, even if they're not at high risk for it, Reuters reported. "The prior recommendations were for screening high-risk adults and adolescents," Dr. Douglas Owens, a member of the USPSTF task force and a Stanford University medical professor, told Reuters. "The current recommendation is for <a href="http://www.huffingtonpost.com/2012/11/19/routine-hiv-screening-us-preventive-services-task-force-uspstf_n_2161090.html">screening everyone</a>, regardless of their risk."

  • 10. People Should Be Treated With Antiretrovirals As Soon As They're Diagnosed WIth HIV

    <em>All</em> HIV patients should be <a href="http://healthland.time.com/2012/07/23/new-advice-calls-for-putting-all-hiv-patients-on-drug-treatment/">treated immediately with antiretrovirals</a>, according to new guidelines issued this year from a panel of the International Antiviral Society-USA, as reported by <em>TIME</em>. The recommendations are counter to previous guidelines, which said that antiretrovirals should only be used if the CD4 count -- a measure of immune cells in a person's body -- becomes less than 350 cells for every mm3 of blood.

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