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Commentary: The monitoring of adults and children on antiretroviral therapy in the 2013 WHO consolidated ARV guidelines.

The laboratory monitoring of patients on antiretroviral treatment (ART) is an important element of HIV treatment programs, and is one of the cornerstones for ensuring a successful and sustained response to ART. Previous WHO ART guidelines placed greater emphasis on treatment initiation, whereas monitoring was considered optimal but not a prerequisite for the rollout of treatment programs [1]. During the early years of the global AIDS response, this was a decision that was both pragmatic and strategic. Treatment access was a public health emergency, and WHO sought to simplify the approach to ART and thus provide member states with guidance that could be implemented without delay. There is little doubt that this was the right thing to do at the time. Global progress in scaling up HIV care and treatment services has been dramatic and unprecedented; many hundreds of thousands of lives have been saved, and close to 10 million adults and children are now receiving ART [2].