The National Aids Control Organization (NACO) has come out with a set of guidelines for antiretroviral therapy in the country. The guidelines are intended as a reference guide for physicians, healthcare providers, national AIDS programme managers and other health planners involved in national HIV care and treatment programmes in India.

The national treatment guidelines for AIDS is expected to ensure structured antiretroviral treatment and thereby introduce a national regimen of fixed dose ARV combinations to be used across the public and private medical practitioners. This would prevent drug resistance, it is learnt.

NACO officials feel that this most recent initiative on treatment for HIV fills a gap in the existing national AIDS control programme, makes it more holistic and comprehensive, and carries forward the process of more directly confronting issues of stigma and discrimination.

The objectives of the NACO guidelines are to provide a standard approach for the use of antiretroviral treatment (ART) to enhance quality of comprehensive HIV/AIDS care in India, to be a source of reference for healthcare providers belonging to various specialties who are involved in providing health care to patients with HIV/AIDS and to be a source of reference to HIV/AIDS programme managers and health planners involved in national HIV care and treatment programmes. It can also be referred by people living with HIV/AIDS, which would ultimately help in training and advocacy at local level. The document contains recommendations for the use of antiretroviral drugs for the treatment of adults and adolescents in India.

According to NACO officials, there is a growing international consensus and pressure that treatment of people living with HIV/AIDS with combination antiretroviral therapy in developing countries is possible. On the basis of clinical data, both, from developed and developing countries, there is evidence that AIDS treatment results in significant gains in extending duration and quality of life. The antiretroviral therapy is known to reduce HIV-related morbidity and mortality, improve quality of life, and restore and/or preserve immunological function and maximal and durable suppression of viral replication.

The guideline talks about various antiretroviral drugs and doses, side effects, choice of regimen, monitoring therapy, adherence, clinical and laboratory monitoring, changes due to adverse effects/intolerance etc.

There are also special chapters explaining how antiretroviral therapy can be carried out in special cases like adolescents, women with special reference to pregnancy, tuberculosis, immune reconstitution syndrome and other opportunistic infections. Detailed account of how to implement the treatment programmes at the ground level is another interesting component of the document.

The release of the National Guideline for Antiretroviral Therapy gains significance in the backdrop of the central government's decision to make available free antiretroviral drugs to HIV/AIDS patients in the country. It was on the eve of World AIDS Day, 2003, the Union Minister for Health & Family Welfare, Sushma Swaraj announced that India would introduce anti-retroviral treatment for people living with HIV/AIDS, in a phased manner across six high prevalence states from April 1, 2004.