HIV EDITORIAL_IN.indd


SEPTEMBER 2014, Vol. 15, No. 3   SAJHIVMED    75

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MESSAGE 
From the Executive
While I was attending the Melbourne International AIDS Society 
(IAS) conference in July, I must admit that I was surprised at the 
announcement by the Minister of Health on the change in our 
eligibility criteria for antiretrovirals (ARVs). He announced that, 
to be in line with the World Health Organization, all HIV-infected 
individuals with a CD4+ count <500 cells/µl should be started on 
antiretroviral therapy (ART), and that all HIV-infected pregnant 
women should initiate lifelong therapy, namely Option B+. �e 
Society congratulates the National Department of Health on 
their willingness to amend South African ARV policy in order to 
treat as many individuals as possible.

In terms of raising the  CD4+ entry level to 500 cells/µl, 
it must be noted that while randomised, clinical trial data 
on the clinical benefit of ART in patients with CD4+ counts 
>350 cells/µl are not yet available, we do recognise that there 
are advantages to having more people on medication. There is 
a clear transmission-prevention benefit in discordant couples 
and there are accumulating data in the community setting.

So, as clinicians, we need to up our counselling game. The task 
of taking lifelong medication is an onerous one. Our current first 
line is not forgiving of missed doses. We, as healthcare workers, 
should have a thorough discussion with patients about the 

potential benefits, uncertainties and side-effects of medication. 
If patients are motivated to stick to their treatment, they should 
be prescribed ART; if they do not yet feel ready, they should 
be given time to work through the issues needed to adhere to 
therapy. Obviously, this would be done with close monitoring of 
their CD4+ counts.

On another note, September 2014 brings our next confe r-
ence. It promises to be packed with interesting debates, excellent 
plenaries and top-notch speakers. For those of you who are 
attending, enjoy the opportunity to network and connect 

with other HIV clinicians. For 
those of you who cannot make it, 
follow our Facebook page (http://
www.facebook.com/SAHIVSoc), 
Twitter account (@SAHIVSoc) 
and the media.

Francesca Conradie
President: Southern African
HIV Clinicians Society 
fconradie@witshealth.co.za

N O N E  S H A L L  B E  D E N I E D

S4  Reg. No. 44/20.2.8/0779

Odimune

Tenofovir DF 300 mg
Emtricitabine 200 mg
Efavirenz 600 mg

“Simplify, simplify.”
Henry David Thoreau

FDC

Philosopher

Cipla Medpro (Pty) Ltd. Reg. No. 1995/004182/07, Building 9, Parc du Cap, Mispel Street, Bellville, 7530, RSA. Tel (021) 943 4200, Fax (021) 914 4699.
E-mail: medicalpa@ciplamedpro.co.za  Website: www.cipla.co.za  Customer Care: 080 222 6662

WHO
PRE-QUALIFIED

3-in-1
ONCE DAILY
FIXED DOSE

COMBINATION

R390.001

FDA
APPROVED

Recommended as preferred 1st line  regimen by national
and international guidelines 2,3

REFERENCE:
1. SEP excl. VAT as per PCD February 2014.
2. The use of antiretroviral drugs for treating and preventing HIV infection (WHO Guidelines-June 2013).
3. The South African Antiretroviral Treatment Guidelines 2013.