THE SOUTHERN AFRICAN JOURNAL OF HIV MEDICINE SEPTEMBER 2005 49 Initiating antiretroviral therapy

when to initiate highly active antiretroviral therapy (HAART) in adults is based on the 2002 WHO guidelines. It is a very conservative guideline, with HAART being initiated with AIDS, diagnosed either clinically (World Health Organization (WHO) stage 4) or immunologically (CD4+ lymphocyte count < 200 cells/µl). The current Southern African HIV Clinicians Society guidelines extend these conservative guidelines to include patients with other evidence of clinical immune suppression (WHO clinical stage 3) and patients with CD4 counts 200- 350 cells/µl. In common with international guidelines, it is recommended that patients in the CD4 stratum 200- 350 cells/µl be followed up until their CD4 count is close to 200 cells/µl, unless their viral load is high. I shall centre my argument on the proposal to use the SA HIV Clinicians Society guidelines to initiate HAART in the public sector