The number of HIV-positive people receiving antiretroviral drugs for their infections jumped by more than a quarter in 2009, growing from 4 million to 5.2 million, the World Health Organization said Monday at the International AIDS Conference in Vienna.
“This is the largest increase in people accessing treatment in a single year. It is an extremely encouraging development,” Dr. Hiroki Nakatani, WHO assistant director-general for HIV, tuberculosis, malaria and neglected tropical diseases, said in a statement.
Unfortunately, that still leaves 10 million who need therapy.
Former President Bill Clinton saluted the increase in a speech at the conference. “Five million people on treatment is a lot compared to where we started, but still [only] a third of those who need treatment today,” he said. “We cannot get to the end of this epidemic without both more money and real changes in the way we spend it.”
About 33.4 million people around the world are now living with the AIDS virus, according to the agency. An estimated 2 million died in 2009, down from 2.2 million in 2004, but the number of newly infected stayed constant at about 2.7 million per year.
The number who need treatment has grown, in part, because UNAIDS last week changed its recommendations on when therapy should begin. In the past, the agency had recommended that treatment begin when a person’s CD4 count, a measure of the severity of an infection, declined to 200 cells per cubic millimeter. That is the point at which AIDS symptoms typically begin to occur. The agency now recommends that treatment begin at a count of 350. A healthy individual has a CD4 count of at least 500 and generally as high as 1,600.
By beginning treatment earlier, the WHO said, patients could be spared many of the complications and opportunistic infections associated with the disease. Reducing their level of virus would also impede transmission to other people, limiting the spread of the virus. “Starting treatment earlier gives us an opportunity to enable people living with HIV to stay healthier and live longer,” Dr. Gilbert Hirnschall, WHO’s new director of HIV/AIDS, said in an interview.
The agency estimated that AIDS-related deaths could be reduced by 20% from 2010 to 2015 if the new recommendation was widely adopted. Tuberculosis deaths, the leading killer of people with AIDS, could be reduced by as much as 90% if people with both HIV and TB infections began treatment earlier.
The cost of HIV treatment in 2010 will be about $9 billion, according to UNAIDS.