HIV Treatment: Everyone with HIV Should Start Medication, Says New Medical Review

A review published by the New England Journal of Medicine confirms that current global guidelines recommend antiretroviral therapy for all people living with HIV, regardless of symptoms or disease stage.

The New England Journal of Medicine (NEJM) has posted details of a new review setting out the current standard of care for HIV treatment worldwide. According to the post, guidelines now recommend that anyone diagnosed with HIV should begin antiretroviral therapy (ART) — medication that suppresses the virus — straight away, without waiting for symptoms to develop or the illness to progress.

That represents a significant shift from older approaches, which sometimes delayed treatment until a patient’s immune system showed signs of decline. The review makes clear that neither the stage of disease, the level of virus in the blood (HIV RNA level), nor the CD4 cell count — a measure of immune system health — should be used as reasons to postpone starting medication.

ART doesn’t cure HIV, but when taken consistently it can reduce the amount of virus in the body to undetectable levels. At that point, according to NHS guidance, a person living with HIV cannot pass the virus on to a sexual partner — a concept known as Undetectable = Untransmittable, or U=U.

For Kent residents, NHS Kent and Medway Integrated Care Board commissions local HIV testing and treatment services. Anyone who thinks they may have been exposed to HIV, or who wants a test, should contact their GP or a local sexual health clinic — no referral is needed for most sexual health services in Kent.

Key information

• NHS 111 can advise on accessing HIV testing and sexual health services in your area
• PEP (post-exposure prophylaxis) — emergency medication that can prevent HIV after potential exposure — must be started within 72 hours; attend A&E or call 999 if you believe you need it urgently
• Free HIV self-testing kits are available through some local authorities and sexual health services in Kent — ask your GP or contact your nearest sexual health clinic for details