• Guidelines for when to start treatment differ around the world because the evidence for using antiretroviral drugs when CD4+ counts are higher wasn’t definitive.
• Since no cure has been found for AIDS and an effective vaccine is far off, the government should invest in ARVs to prioritize their needs, which will reduce new infections.
Kenya has the third-largest HIV epidemic in the world, with 1.6 million people living with HIV in 2018.
In the same year, 25,000 people died from Aids-related illnesses. While this is still high, the death rate has declined steadily from 64,000 in 2010.
This makes HIV one of the country's major infections, having a devastating effect on health and the economy.
In 1996, 10.5 per cent of Kenyans were living with HIV, although prevalence has almost halved since then, standing at 5.9 per cent by 2015.
This progress is mainly due to the rapid scaling up of treatment and care. In 2016, 64 per cent of people living with HIV were on treatment, 51 per cent of whom were virally suppressed.
HIV in Kenya is driven by sexual transmission and is generalised, meaning it affects all sections of the population including children, young people, adults, women and men.
As of 2015, 660,000 children were recorded as being orphaned by Aids.
Aids is caused by HIV, a retrovirus that attacks the immune system. The virus destroys CD4+ T cells, a type of white blood cell that is vital to fighting off infection.
The number of these cells, known as a CD4+ count, is a key measure of immune system health.
After people get infected with HIV, their immune system becomes progressively weaker from the HIV infection, their CD4+ count drops, and eventually, they develop Aids.
Aids is treated with antiretroviral drugs. These drugs suppress HIV but don’t eliminate the virus from the body.
Guidelines for when to start treatment differ around the world because the evidence for using antiretroviral drugs when CD4+ counts are higher wasn’t definitive.
Some experts felt it's prudent to wait until the disease progressed to CD4+ a level at which there was a proven benefit.
Effective antiretroviral therapy is the most important intervention in terms of improving longevity and preventing opportunistic infections in patients with HIV.
Therapy should involve combinations of drugs recommended by current guidelines.
Recommendations are specific for various patient groups (e.g. treatment-naive, treatment-experienced, confection with hepatitis C), antiretroviral drug classes and agents to people living with HIV.
Since no cure has been found for Aids and an effective vaccine is far off, the government should invest in ARVs to prioritise their needs, which will reduce new infections.
Youth Advocate Reproductive Health Network Kenya
Edited by Kiilu Damaris