Monday, May 18, 2009

HIV and ARV Treatment

A study just came out demonstrating that the mortality rate of HIV patients can be cut in half when ARV therapy is initiated concurrently with treatment for opportunistic infections. The study was conducted by researchers at University College Dublin and Stanford (!). Currently, when patients are diagnosed with AIDS late in the disease process, doctors treat them for their complications (the opportunistic infections) but do not start them on ARVs at the same time because they fear that the two therapies will have negative effects on one another. Basically, the doctors try to treat the acute disease before dealing with the underlying issue. However, this study shows clearly that early ARV treatment cuts deaths in half by 50%.

The study was conducted over 3 years in the US and in South Africa. Not only was the number of deaths halved by treating early, but the T cell counts also rose much more quickly in the patients who were treated early. By improving the immune system of the patient, early ARV initiation allows the patient to then fight infection better. The study has significant clinical implications and is already leading to changes in medical treatment practices. The findings are most relevant to migrant workers and injection drug users, who are often diagnosed with HIV late in the disease progression.

I like this study because it has direct clinical implications - that is, its recommendations can be immediately adopted by doctors and the outcomes of the new practices should become immediately apparent. There is no excuse for bench-to-bedside dilly-dallying...this research can be translated right away into changes that save lives.

Cooper

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