NEW DELHI– The World Health Organization has strongly recommended CD4 testing as the preferred method for identifying advanced HIV disease among people living with HIV, as part of its newly released 2025 guidelines.
According to the WHO, advanced HIV disease remains a leading cause of AIDS-related deaths worldwide, even in countries with strong HIV testing and treatment coverage. The organization defines advanced HIV disease in adults, adolescents, and children aged five years and older as a CD4 cell count below 200 cells per cubic millimeter.
The WHO said advanced HIV disease continues to pose a serious public health challenge despite progress toward global targets for HIV diagnosis, treatment, and viral suppression.
Under the updated guidance, all children living with HIV who are younger than five years should be considered as having advanced HIV disease unless they have been on antiretroviral therapy for more than one year and are clinically stable.
The WHO said the 2025 guidelines address the need for improved methods to identify advanced HIV disease and to improve outcomes for people living with HIV, particularly those being discharged from hospitals.
While CD4 testing is recommended as the primary tool, the WHO said clinical staging may be used in settings where CD4 testing is not yet available.
The guidelines recommend CD4 testing for people living with HIV who are starting or restarting antiretroviral therapy, returning to care after a period of disengagement, experiencing treatment failure, or who are hospitalized, seriously ill, or clinically unstable.
The WHO said CD4 testing can also help identify possible treatment failure when viral load testing is unavailable and can be used to determine eligibility for stopping co-trimoxazole prophylaxis or starting fluconazole prophylaxis.
For hospitalized patients with HIV, the guidelines emphasize supportive interventions to ease the transition to outpatient care and reduce avoidable hospital readmissions. These measures may include discharge planning, medication reviews, follow-up calls, home visits by healthcare workers or peer supporters, and individualized care support.
The WHO also recommended specific drug treatments for people living with HIV who develop Kaposi’s sarcoma, a rare cancer affecting blood and lymph vessels, including paclitaxel or pegylated liposomal doxorubicin.
The guidelines stress the importance of early detection, rapid initiation of antiretroviral therapy, and optimized clinical management to reduce illness and deaths associated with HIV.
The WHO said implementing these recommendations could help countries reduce severe disease, improve treatment outcomes, and advance global efforts to eliminate HIV-related mortality. (Source: IANS)
