All HIV-infected to get antiretroviral therapy

Kathmandu, October 7

The government is planning to provide antiretroviral therapy to all infected people from next year.

According to National Centre for AIDS and STD Control under the Department of Health Services, it has been working to provide ART treatment to all people infected with HIV.

“We have been working to implement a new guideline,” said Sambhu Kafle, an official at NCASC, adding that all HIV-infected people will get ART treatment, once the new guideline is enforced.

According to Kafle, the new guideline has been revised on the recommendation of the World Health Organisation. He informed that the NCASC had been providing ART to HIV-infected people, whose CD4 count was below 500 cells. Doctors recommend ART medication only after examination of their CD4 status.

“Once the new guideline is enforced CD4 count report is not needed to start ART medication,” he added. Doctors say that CD4 cells are one of the specialised cells, which help protect the body from infection. Immune system employs the CD4 or T-cells to identify and target ineffective agents like HIV.

NCASC has been providing CD4 count services from district hospitals across the country.

Meanwhile, the National Public Health Laboratory of the Department of Health Services said it was planning to phase out the CD4 count service. Officials said CD4 counts have become irrelevant, as they have to start antiretroviral therapy drug at the time of diagnosis.

“We are planning to phase-out CD4 count, as it is no longer used to determine when the antiretroviral therapy should start,” said Dr Geeta Shakya, director at  NPHL.

Doctors, however, say CD4 count is still necessary in the country like Nepal, as it shows actual condition of a person’s immune strength and response to the drugs.

“Even if the drug is started at the time of diagnosis, CD4 count service is needed to ensure that the medicine is working properly and the infected people are recovering,” said Dr Anup Bastola of the Sukraraj Tropical and Infectious Disease Hospital. He said HIV-infected patients come to the STIDH in critical stage and their CD4 drops to less than 100.