Evaluating HIV treatment as prevention in the European context

public health guidance

This report, commissioned by ECDC and produced by the Research Department of Infection and Population Health, University College London, gathers evidence regarding population-level, and to some extent, individual-level effects of the use of antiretroviral treatment to prevent HIV infection, and relating it to current HIV treatment guidelines. The report concludes that antiretroviral treatment has well documented benefits in reducing transmission of HIV, and has had major population level impact on HIV acquisition in children from HIV positive mothers. However it goes on to state that this policy cannot be used for all people with diagnosed HIV without understanding whether there is a benefit for personal health.

Executive summary

In this scenario of ongoing HIV transmission, ECDC’s report Evaluating HIV treatment as prevention in the European context gathers evidence regarding population-level, and to some extent, individual-level effects of the use of antiretroviral treatment to prevent HIV infection, and relates this evidence to current HIV treatment guidelines.

Formal literature reviews were performed for the three main areas of interest: the effect of antiretroviral therapy in adults on preventing the sexual transmission of HIV, prevention of mother-to-child transmission and post exposure prophylaxis.

The ECDC report concludes that antiretroviral treatment has well-documented benefits for reducing the transmission of HIV, and has had a major impact on reducing HIV acquisition among children born to HIV positive mothers. However, the policy of treatment as prevention cannot be universally applied to all persons diagnosed with HIV without understanding whether there is a benefit for the individual’s health. Further research will be needed in order to understand how antiretroviral therapy can help to prevent HIV infections through other transmission routes, and to develop evidence-based policy recommendations.

Antiretroviral therapy is treatment of people infected with HIV using anti-HIV drugs. Standard antiretroviral therapy combines at least three antiretroviral drugs to suppress the HIV virus and stop the disease from progressing. While the treatment has the potential to reduce mortality and morbidity rates among HIV-infected people, it cannot cure HIV or AIDS.

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