The World Health Organization (WHO) recently presented updated scientific and normative advice on human immunodeficiency virus (HIV) during the 12th International AIDS Society Conference on HIV Science in Australia. In addition to this, the UN health agency urged nations to integrate mpox (monkeypox) detection, prevention, and care into existing and novel HIV and sexually transmitted infection (STI) prevention and control initiatives. These guidelines have the potential to transform the management of HIV and its associated risks globally.
Emphasizing the Role of HIV Viral Suppression
The updated WHO guideline emphasizes the critical role of HIV viral suppression and undetectable virus levels in enhancing individual health and preventing the transmission of the virus. Studies have shown that when people living with HIV consistently use antiretroviral therapy (ART) and achieve an undetectable level of the virus in their blood, they become virtually non-infectious. This means that they do not transmit HIV to their sexual partner(s), effectively reducing the risk of transmission.
The concept of “Undetectable = Untransmittable” (U=U) has gained significant momentum in recent years, reducing the stigma associated with HIV and encouraging people to seek treatment early. This update reaffirms the importance of HIV treatment adherence and viral load monitoring for both individual health outcomes and public health goals.
Integrating Mpox Detection, Prevention, and Care
In a notable move, the WHO urged countries to integrate mpox (monkeypox) detection, prevention, and care with existing and innovative HIV and STI prevention and control programs. Monkeypox is a rare but potentially serious viral disease that can cause symptoms similar to smallpox, though usually milder. The integration of mpox management with existing HIV programs aims to leverage existing infrastructures, resources, and expertise to address both health challenges effectively.
By integrating mpox care with HIV care, health systems can strengthen their capacity to identify and manage infectious diseases comprehensively. This approach is crucial, especially in regions where both HIV and mpox are prevalent, and resources might be limited.
Reducing Vertical Transmission of HIV
Another critical aspect of the updated guidelines is its focus on reducing vertical transmission of HIV. Vertical transmission refers to the transmission of the virus from an HIV-positive mother to her child during pregnancy, childbirth, or breastfeeding. The guideline highlights that people living with HIV who achieve an undetectable viral load through consistent use of antiretroviral therapy are at low risk of vertically transmitting HIV to their children.
This finding is a major breakthrough in the prevention of mother-to-child transmission (PMTCT) of HIV. By supporting and ensuring the adherence of pregnant women to ART, health authorities can significantly reduce the risk of HIV transmission to newborns, ultimately moving closer to the global goal of eliminating pediatric HIV infections.
