A new cascade of HIV care for the era of "treat all"

Area of Science:

• Public Health
• Infectious Diseases
• Clinical Medicine

Background:

• The global HIV/AIDS epidemic remains a significant public health challenge.
• Effective antiretroviral therapy (ART) is crucial for managing HIV infection and preventing transmission.
• Current HIV care cascades often rely on CD4 cell count thresholds, which can delay treatment initiation.

Purpose of the Study:

• To describe an adapted cascade of HIV care.
• To evaluate the implementation of World Health Organization (WHO)-recommended ART strategies.
• To assess the feasibility of initiating ART irrespective of CD4 cell count.

Main Methods:

• The study discusses a conceptual model for an adapted HIV care cascade.
• It reviews WHO guidelines for universal testing and treatment.
• The approach emphasizes integrating ART initiation into routine HIV services.

Main Results:

• An adapted cascade allows for earlier ART initiation.
• This strategy simplifies care pathways and potentially improves patient outcomes.
• It aligns with the WHO's "test and treat" policy.

Conclusions:

• Adapting the HIV care cascade to WHO recommendations simplifies treatment initiation.
• Initiating ART irrespective of CD4 cell count can enhance HIV management.
• This approach holds promise for improving global HIV control efforts.