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Study shows Aids drugs do work
04/03/2005 09:38 - (SA)
Paris - A long-term study into anti-HIV drugs confirms their ability to control the Aids virus and suggests that, in the right conditions, the proportion of patients who fail to respond to these vital medications can be kept low and stable.
The finding is unexpectedly good news, for it runs counter to the mainstream belief that highly active antiretroviral therapy (HAART) is at risk from growing resistance by the stealthy human immunodeficiency virus (HIV).
The research derives from patient records at six large Aids clinics in Britain, where 16 593 people with HIV were treated between 1996 and 2002.
By the end of 2002, mortality in this group had fallen to around eight percent, "between 10 and 20%" of the death toll before the HAART drug cocktail became available in the mid-1990s, said lead researcher Caroline Sabin.
Mortality fell by 80%
In addition, the number of people with a dangerously low level of CD4 immune cells, which are targeted by HIV, fell from 38 to 13%.
And those with a dangerously high level of HIV in their blood fell from 89% to 23.5%.
The figures back previous evidence that the advent of HAART has revolutionised Aids care.
A study published in The Lancet in October 2003 found that mortality fell by 80% when comparing the pre- and post-introduction of the drugs.
HAART comprises a combination regimen of pills designed to inhibit reproduction of HIV at various points in the virus cycle.
There are three classes of these drugs: protease inhibitors, nucleoside reverse transcriptase inhibitors and non-nucleoside transcriptase inhibitors.
In many cases, HAART can reduce HIV loads to below detectable levels.
But it is not a cure. If the drugs are stopped, the virus bounces back.
There are also problems with toxicity and intolerance to the drugs among some individuals, as well as resistance, which occurs when the virus mutates and eludes the drug formula.
But the new research, which is published in Saturday's issue of the British Medical Journal (BMJ), suggests that resistance can be somewhat less of a problem than is widely feared.
Of the people who had tried all three classes of HAART drugs about 15%experienced treatment failure.
The level was attained quickly after the drugs were introduced but then remained remarkably stable in the following years.
Sabin, a professor at the Department of Primary Care and Population Sciences at London's Royal Free and University College Medical School, said there was an urgent need to develop new, low-toxicity HAART drugs to get around the resistance problem.
But, she said in an interview with AFP, she was surprised that the level of treatment failure had remained relatively low and stable.
- AFP
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