Academic journal article Bulletin of the World Health Organization

Study Confirms Effectiveness of Antiretroviral Drugs for HIV Patients

Academic journal article Bulletin of the World Health Organization

Study Confirms Effectiveness of Antiretroviral Drugs for HIV Patients

Article excerpt

An international team of researchers looking at more than 7700 HIV patients undergoing combination therapy with antiretroviral (ARV) drugs has reported an increase in survival rates and a significantly reduced risk of progression to full-blown AIDS.

"Predicted survival for people with HIV-1 has continued to increase, since the introduction of HAART [highly active antiretroviral therapy]," say the authors--a collaborative team funded largely through a grant from the European Union. The study found that compared with pre- 1997 data--when ARVs were first introduced to curb viral replication--the hazard ratio for death fell sharply to 0.47 (95% confidence interval (CI) = 0.39-0.56) in 1997, dropping further to 0.16 (CI = 0.124).22) in 2001. The authors also said that, compared with pre-1997 data, the hazard ratio of disease progression was 0.46 (CI = 0.38-0.55) in 1997, falling to 0.13 (CI = 0.09-0.21) by 2001.

"The study shows that ARVs are among the most effective health care interventions. When you compare them, for instance, to anticancer drugs or to anti-hypertensives, ARVs are orders of magnitude better," said Dr Jos Perriens of the World Health Organization's HIV/ AIDS department. The study, published in the Lancet, (2003;362:1267-74), compared disease progression and death rates in the period prior to 1997 to the period between 1999 and 2001, when ARVs were widely available to most, if not all, HIV patients in high-income countries.

The study's results, based soley on HIV-positive cohorts in Europe, Australia and Canada, show that ARVs prolong the lives of HIV patients in industrialized countries where hospitals are well equipped with state-of-the-art laboratory facilities. However, numerous small-scale pilot projects run by UNAIDS, a French initiative called the International Therapeutic Solidarity Fund (FSTI) and nongovermnental organizations such as Medecins Sans Frontieres--as well as the Brazilian national AIDS programme--have since demonstrated the feasibility of ARV treatment even in resource-poor settings.

"In terms of patient compliance and survival rates, ARVs do indeed work extremely well in developing countries-even when compared to best practise in the industrialized world," said Peter Graaff of WHO's Essential Drugs and Medicines Policy (EDM) who also added that their therapeutic effectiveness was the reason for EDM'S move to include ARVs on WHO's model list of essential drugs last April. …

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