Health Minister Aurelius Veryga has signed an order for patients with human immunodeficiency virus (HIV) to start treatment immediately after being diagnosed with it, as opposed to having to wait for the virus to progress. This treatment is expected to be covered by the Mandatory Health Insurance Fund (PDSF).
Previously, patients who were HIV positive would have to wait for their CD4 count to be between 200 and 350 cells/mm3. This test is used as a snapshot to evaluate how the immune system is functioning. A healthy CD4 count ranges from 500 – 1500 cells/mm3, and HIV develops into AIDS when the CD4 count drops bellow 200 cells/mm3.
Minister Veryga says “from now on, all infected with this virus will receive treatment in a timely manner. The new treatment scheme has been approved to ensure that HIV-infected people start treatment immediately. This will increase the likelihood of a high-quality, full-fledged life and reduce the spread of the disease. For example, when taking antiretroviral drugs at the time of pregnancy and with other prophylaxis, the chance of transmitting the virus to the new-born significantly decreases. Meanwhile, by doing nothing, roughly every second HIV-infected pregnant will transmit the virus to their new-born”.
The National LGBT* Rights Organization LGL welcomes these positive developments. According to the LGL’s Policy Coordinator (Human Rights) Tomas V. Raskevičius, the immediate treatment will not only improve the health status of HIV+ individuals, but also significantly reduce the number of new transmissions. “We are very pleased to learn that HIV treatment will be available immediately after the diagnosis,” – commented Mr. Raskevičius. “Nevertheless, we should remember that effective response towards HIV+/AIDS phenomenon consists of not only effective and accessible treatment, but also corresponding prevention strategy. We further encourage the Ministry of Health and other competent public health institutions to develop preventive measures, specifically targeting various social groups at risk, including local LGBTI community.”
When early diagnosis and treatment are available, viral load suppression is more likely to be quickly achievable. With viral load suppression, the virus becomes undetectable by regular blood tests, and the risk of sexually transmitting the virus comes close to zero. The PARTNER study reported zero HIV transmissions from a positive partner on antiretroviral treatment to their negative partner (based on straight and gay couples, with more than 58,500 acts of condomless sex). The Oposittes Attract study, which followed 343 serodiscordant gay couples across Australia, Bangkok and Rio de Janeiro, came to the same results, with 0 transmission of HIV in 16,889 acts of condomless sex.
The World Health Organization and the European AIDS Clinical Society recommend starting treatment immediately after the virus has been detected. Thus, this order aligns with international standards, and it could be an important step not only towards effective treatment, but also for the prevention of new HIV transmissions in Lithuania.
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