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Fight against Advanced HIV Disease gains momentum

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African health leaders have concluded a crucial meeting aimed at enhancing the diagnosis and treatment of advanced HIV disease (formerly known as AIDS).

The two-day held in Nairobi brought together HIV clinicians, researchers, supply chain specialists, civil society and community groups from across Africa, as well as donors and global stakeholders.

They sought to find solutions on treatment accessibility, facilitate policy changes, and improve the supply chain to end AIDS-related mortality.

Kenya’s head of HIV treatment and prevention services Dr Rose Wafula noted the urgent urgent need for concerted action to prevent, diagnose, treat, and follow up with Advanced HIV disease adding that governments must be at the forefront in fight against the disease.

“I am particularly delighted by the presence of government officials and leaders from various countries in sub-Saharan Africa. It is the prerogative of governments to offer leadership and commitment to providing an enabling environment, secure resources, and implement policies towards ending AIDS-related mortalities in Sub-Saharan Africa,” she said.

Advanced HIV represents a critical stage in HIV infection where the immune system becomes severely compromised, leading to increased vulnerability to opportunistic infections.

A person with HIV is considered to have advanced HIV disease (AHD) if their CD4 count falls below 200 cells or they show symptoms of HIV clinical stages 3 or 4, according to the WHO classification system.

These late stages are usually characterised by tuberculosis, cryptococcal meningitis, and severe bacterial infections. The World Health Organization reports that 630,000 people died of AIDS-related illnesses in 2022.

“Analysis of our own program data shows that up to 1 out 3 persons living with HIV who are either new on treatment, with treatment failure or returning to care after interruption are presenting with AHD,” said Dr Wafula.

According to Dr Wafula, Kenya had 18,000 AIDS-related mortalities in 2022, the majority of whom were caused by TB and Cryptococcal meningitis. Despite advancements in access to antiretroviral treatment, hundreds of thousands of people with advanced HIV die each year from

Currently, the Drugs for Neglected Diseases Initiative (DNDi) in Nairobi is spearheading efforts to innovate treatment options for AHD.

Collaborating with partners, they are working on reformulating flucytosine treatment into a sustained-release formulation, which promises to enhance treatment adherence and streamline healthcare delivery.

“Advanced HIV disease is often neglected in terms of research and tool development. While HIV has received considerable attention, AHD continues to suffer from limited innovation and resource allocation,” explained Professor Samuel Kariuki, the Eastern Africa DNDi Director.

Professor Samuel Kariuki, Eastern Africa Director, DNDi.

According to the World Health Organisation (WHO) an estimated 2 million people are living with HIV in sub-Saharan Africa, and more men than women have the disease.

“Men in sub-Saharan Africa are much more likely to have advanced HIV disease than women, despite fewer men having HIV overall,,” said Ajay Rangaraj, the advanced HIV diseases lead at WHO.

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