Advanced HIV disease (defined in persons living with HIV with a CD4 cell count of <200cells/mm3 or presenting with a WHO Stage 3/4 AIDS-defining illness) poses a challenge to many countries globally and is responsible for significant mortality and morbidity among people living with HIV. In 2017, WHO... recommended a package of care for the prevention and management of advanced HIV disease. The package was composed of screening tests, diagnostics, prophylaxis, rapid antiretroviral therarpy initiation and enhanced adherence counselling.
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Cryptococcal disease is one of the most common opportunistic infections among people living with advanced HIV disease and is a major contributor to severe illness, morbidity, and mortality, particularly in sub-Saharan Africa.
These guidelines update the recommendations that were first released i...n 2018 on diagnosing, preventing, and managing cryptococcal disease. In response to important new evidence that became available in 2021, these new guidelines strongly recommend a single high dose of liposomal amphotericin B as part of the preferred induction regimen for the treatment of cryptococcal meningitis in people living with HIV. This simplified regimen - a single high dose of liposomal amphotericin B paired with other standard medicines (flucytosine and fluconazole) - is as effective as the previous WHO standard of care, with the benefits of lower toxicity and fewer monitoring demands.
The objective of these guidelines is to provide updated, evidence-informed recommendations for treating adults, adolescents and children living with HIV who have cryptococcal disease. These guidelines are aimed at HIV programme managers, policymakers, national treatment advisory boards, implementing partners and health-care professionals providing care for people living with HIV in resource-limited settings with a high burden of cryptococcal disease.
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Cryptococcal disease, particularly cryptococcal meningitis is a significant cause of morbidity and mortality among people living with HIV with advanced HIV disease. It is estimated that it is responsible for nearly 19% of AIDS-related mortality, second only to tuberculosis. Rapid screening, diagnosi...s and linking to appropriate treatment are critical actions national programs must take to reduce the burden of disease.
WHO in 2022 introduced updated guidelines for diagnosing, preventing, and managing cryptococcal disease among adults, adolescents and children living with HIV. This policy brief provides a summary of the key recommendations, clinical considerations, and also stresses the importance of ensuring access to life-saving antifungals. There is an urgent need for countries to scale-up management for not just cryptococcal meningitis, but address cryptococcal disease in the context of a package of care for advanced HIV disease as recommended by WHO.
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Version dated April 1st, 2020.
The flow of migrants and refugees from Venezuela constitutes the largest mobilization of people in the history of Latin America. By March 2020, more than 4.9 million Venezuelans have left their country and from these, more than 4.1 million have been mobilized to count...ries in Latin America and the Caribbean. The motives for this mobilization are diverse, but those related to health care issues stand out, among which is the condition of living with HIV/AIDS. In the situation of demand for medical care that COVID-19 has generated, it is much more difficult to receive attention for people who are not included in the health systems of countries that are recipient due to the limitations that their migratory status may impose.
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It is estimated that prior to the war there were more than 250 000 people (1% of total population) living with HIV in Ukraine, of whom around 130 000 were receiving antiretroviral therapy.
As the displacement of people from Ukraine escalates, it is imperative that countries across Europe receivin...g these displaced people are prepared to ensure high standards of HIV prevention, treatment and care.
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Advocacy achievements of the bridging the gaps global partners
Accessed: 17.11.2019
Translated and adapted from the original English Antiretroviral drugs chart by the East Europe and Central Asia Union of People Living with HIV (ECUO). This resource shows drugs currently available in the Eastern Europe and Central Asia area.
Last update Oct. 2018
People living with HIV who have a low CD4 count are at a much higher risk of falling ill from TB infection than HIV negative people.
It is important to offer both HIV testing to TB patients and TB diagnosis in HIV patients. Early detection and effective treatment are essential to preventing TB...-associated deaths.
WHO and UNAIDS have strongly advised countries to ensure that HIV programmes integrate regular TB screening, preventive therapy and early treatment.
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People living with HIV depend on life-saving antiretroviral therapy (ART) and access to ART must be maintained during periods of travel restrictions and lockdowns resulting from the COVID-19 pandemic. The Information note on HIV and COVID-19 addresses common concerns people living with HIV have rega...rding the risks of COVID-19 and how to minimize them. For HIV programme managers and health facilities providing HIV services, it identifies key points related to ensuring uninterrupted provision of ART, while protecting clients and staff from the risk of infection with the SARS-CoV-2 virus.
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Findings from the People Living with HIV Stigma Index
Penal Implications for People Living with HIV/AIDS
In 2015 around 15 million people living with HIV were receiving antiretroviral treatment (ART) in sub–Saharan Africa. Sustained provision of ART, though both prudent and necessary, creates substantial long–term fiscal obligations for countries affected by HIV/ AIDS. As donor assistance for healt...h remains constrained, novel financing mechanisms are needed to augment funding domestic sources. We explore how Innovative Financing has been used to co–finance domestic HIV/AIDS responses. Based on analysis of non–health sectors, we identify innovative financing instruments that could be used in the HIV response.
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The new WHO guidelines recommend that people living with HIV be started on antiretrovirals (ARVs) as soon as possible after being diagnosed. Currently, many people living with the virus globally must wait until their CD4 counts fall to 500 to start treatment. According to the WHO, the move to early ...treatment –or what some have dubbed the “test and treat” model –is backed by the latest research.
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Information Note
1 of every 22 people living with HIV
was affected by
a humanitarian emergency in 2013
The report shows that where people and communities living with and affected by HIV are engaged in decision-making and HIV service delivery, new infections decline and more people living with HIV gain access to treatment. When people have the power to choose, to know, to thrive, to demand and to work... together, lives are saved, injustices are prevented and dignity is restored.
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The objectives of these guidelines are to provide recommendations outlining a public health approach to managing people presenting with advanced HIV disease, and to provide guidance on the timing of initiation of antiretroviral therapy (ART) for all people living with HIV.
WHO recommends that a... package of screening, prophylaxis, rapid ART initiation and intensified adherence interventions be offered to everyone living with HIV presenting with advanced disease.
WHO strongly recommends that rapid ART initiation should be offered to people living with HIV following confirmed diagnosis and clinical assessment. Rapid initiation of ART is defined as within seven days of HIV diagnosis. WHO further strongly recommends ART initiation on the same day as HIV diagnosis based on the person’s willingness and readiness to start ART immediately, unless there are clinical reasons to delay treatment.
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Tuberculosis (TB) is the leading cause of illness and death among people living with HIV. TB can be cured.
12 January 2021
The COVID-19 vaccines under development or approved by regulators are believed to be safe for most people, including people living with HIV.
This document is also available in Arabic and Portuguese.