Question

Are there still differences in treatment guidelines?

4 January 2016. Related: All topics.

I know for many years there were difference between UK and US guidelines – is this still the case?

What about guidelines in low income countries, especailly over when to start treatment.

Answer

Answer: Simon Collins

Thank-you for your question.

Sometimes guidelines are dufferent in different countries. For example, for many years the UK and US quidelines had different recommendations for when to start HIV treatment (ART). Or WHO guidelines for low-income countries might be different.

These differences were usually due to different interpretations of research and different approaches to healthcare.

Luckily, in 2016 most quidelines are now very similar. This includes broadly recommending ART for all people living with HIV. This include recommenidng ART for all HIV positive people in both high and low income countries.

When there is limited access to ART, those with the lowest CD4 count have a priority for access to ART.

There are still a feww differences in choice of drugs in some countries.

WHO guidelines for low- and middle-income countries still widely recommend efavirenz. In 2016, guidelines for high-income countries have generally moved to recommend integrase inhibitors rather than efavirenz.

This question was posted in 2016 to update this question from April 2012.