At the moment, people in the public sector can only get the medication when their CD4 count, which measures the level of immunity in the blood, drops to 200.

But the World Health Organisation recommends that people should be able to start ARVs when their CD 4 count drops to 350.

Dr Nomonde Xundu, Chief Director of the HIV/AIDS cluster in the national Department of Health, confirmed that new HIV treatment guidelines had been ‘€œinterrogated quite extensively’€.

They had been discussed within the department, presented to the National Health Council and discussed with the treatment task group of the SA National AIDS Council, said Xundu.

However, Xundu would not reveal the new recommendations as ‘€œthere’€™s no decision that has been made around them’€.

However, a source close to the discussions said that the government seemed to favour lowering the bar only slightly, making the cut-off for treatment at a CD4 count of 250.

Nonkosi Khumalo, chairperson of the Treatment Action Campaign (TAC), said that her organisation favoured 350 as the cut-off.

‘€œWith [a CD4 count of 350], the person is more tolerant of the drugs, which are potent and have side-effects. Also when you reach a CD4 count of 200, you susceptible to more opportunistic infections,’€ said Khumalo.

The Southern African HIV Clinicians’€™ Society has already adopted the WHO recommendation that CD4 350 be the starting point.

The WHO is particularly concerned that pregnant women with HIV should start taking ARVs when they have a CD4 cell count of 350 to decrease their viral load and thus reduce the ease the risk of transmitting HIV to their unborn babies.

Xundu confirmed that the health department was revising treatment guidelines for pregnant women with HIV.

Meanwhile, the TAC also wants the Department of Health to broaden the choice of available antiretroviral medicines in order to deal with side-effects and resistance to existing regimes.

South Africa has only two regimens, and if people develop resistance to these, there is no alternatives.        

‘€œWe need to increase the availability of the new drugs, which are very important and have less side-effects, like your Truvadas and Tenofovir, which are already available in the private sector,’€ said TAC’€™s Khumalo.