Combination Therapy For HIV Infection Impacts Mortality
WESTPORT, Nov 10 (Reuters) - The new combination antiretroviral treatments for HIV infection have significantly improved survival and reduced rates of disease progression, according to members of the Swiss HIV Cohort Study.
Compared with HIV-positive patients who began treatment between 1988 and 1990, patients starting treatment between 1995 and 1996 with the newer regimens had a 73% reduction in risk of progression to AIDS and a 62% reduction in mortality, according to a report in the November 8th issue of the British Medical Journal.
Dr. Matthias Egger of the University of Berne and colleagues conducted a prospective study of more than 5,000 HIV-positive individuals attending one of seven HIV units in Switzerland. The cohort study, which began in 1988, is one of the largest worldwide and contains a large number of women as well as individuals from all three of the major HIV transmission groups.
After reviewing data representing more than 15,000 person-years of follow-up, Dr. Egger's group found that both mortality and risk of progression to AIDS decreased over time. In particular, reductions were most pronounced starting in 1995-1996, the period when antiretroviral combination therapy with two nuclease analogues and a protease inhibitor was introduced. These reductions were seen in both men and women, and among individuals in all HIV transmission groups.
"The crucial question is whether these improvements will last," Dr. Egger's team points out. "The emergence of resistant HIV variants remains a serious threat," they add. However, these substantial improvements in prognosis for HIV-positive patients in Switzerland will "...hopefully lead to sustained improvements in the future."
Efforts are now needed to make these treatments available to all HIV-infected individuals, including those who live in countries with poor resources, they say. "It is equally if not more important that efforts to prevent new infections continue unabated, both in industrialised and in less developed countries." |
