Hiv / Aids And Aids

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The African continent represents 12% of the worlds population, but Sub-Saharan Africa disproportionately represents nearly 70% of the worlds HIV cases (1). Within that, it has been estimated that there are 6.1 million people living with HIV/AIDS in South Africa, which is the highest number from any country in the world (2), and represents 17% of the global burden of HIV infection (3).

HAART has been the mainstay of treatment for HIV in industrialised countries since the 1990’s (4). Since its widespread introduction, it has changed the course of the epidemic dramatically and improved survival and quality of life of people living with HIV/AIDS (5). HAART consists of three different antiretroviral drugs, given in combination.

In 2013 the World Health Organisation (WHO) released its updated guidelines for the use of HAART in HIV/AIDS (Appendix 1), providing recommendations for policy and decision makers for more widespread use of HAART (6). These guidelines also raised the recommended threshold for initiation of HAART from CD4<350cells/mm3 to CD4<500cells/mm3 in asymptomatic patients (6), with a note that priority for starting treatment still remained with individuals with lower CD4 counts (<350cells/mm3). Despite this continuing expansion of HAART eligibility, uptake remains low in many places, with only 54% of those eligible for HAART with a CD4<350cells/mm3 receiving it worldwide (7).

Low and middle-income countries, like South Africa, are faced with the
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