Study Confirms Power of Anti-HIV Drugs

Combination therapy is keeping patients alive over long term

THURSDAY, July 28, 2005 (HealthDayNews) -- The powerful cocktail of drugs known as highly active antiretroviral therapy (HAART) prevents HIV infection from progressing to AIDS in a majority of patients over the long term, researchers report.

Based on these findings, experts in Britain contend that HAART is appropriate for treating HIV infection where it has hit hardest -- in developing countries.

The report appears in the July 30 issue of The Lancet.

"Compared with no treatment, HAART, which has been available since 1996, reduces the progression for HIV to AIDS and death by 86 percent," said Jonathan A.C. Sterne, a reader in medical statistics at the Department of Social Medicine at the University of Bristol.

"In addition, the benefit of HAART increases with time since starting treatment," he noted. In other words, the longer one waits to start treatment, the more the immune system becomes compromised, reducing the benefit of HAART, Sterne explained.

HAART involves a combination of three and sometimes more drugs that work in combination to suppress the activity of HIV. First discovered in the mid-1990s, the therapy has greatly extended the lives of thousands of infected individuals in the developed world. The drugs are expensive, however, and have so far remained out of reach of most HIV-positive individuals living in poorer countries.

In their study, Sterne's team collected data on 3,245 HIV patients who participated in the Swiss HIV Cohort Study starting in 1996, when HAART first became available to Swiss patients. They compared the outcomes of patients receiving HAART to those of patients receiving no treatment, and with patients receiving only two HIV drugs.

The researchers report that HAART was effective in preventing long-term progression to AIDS. But they also found that people who became infected with HIV via injection drug use were less likely to benefit from HAART than other patients. "This might be because these people adhere to treatment less well," Sterne said.

HAART does have side effects, including an increased risk of heart disease, Sterne noted. "These results provide reassurance that there are very big benefits of the treatment that outweigh the adverse effects," he said.

The British researcher believes the study clearly shows the value of HAART over time. "These results show the huge potential benefit of making HAART available in developing countries, in particular in sub-Saharan Africa," Sterne said. "The benefits are so enormous that there are huge potential gains by trying to making HAART accessible in developing countries."

One expert said the findings come as little surprise. "This study is a statistical analysis to prove what we already know clinically," said Michael Allerton, the HIV operations policy leader at the Permanente Medical Group in Oakland, Calif.

"To my mind, the only time anyone had any doubt about HAART working was in South Africa, with the president of South Africa [Thabo Mbeki], who doesn't believe that HIV causes AIDS," Allerton said. "The concern is not if it works, but how you find an effective way to distribute it that it continues to maintain its efficacy."

More information

The U.S. Centers for Disease Control and Prevention can tell you more about HIV/AIDS.

SOURCES: Jonathan A. C. Sterne, Ph.D., reader, medical statistics, Department of Social Medicine, University of Bristol, United Kingdom; Michael Allerton, M.S., HIV operations policy leader, The Permanente Medical Group, Oakland, Calif.; July 30, 2005, The Lancet
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