HIV treatment in Africa as successful as in Europe, if started in time

Jul 08, 2008

The public health approach to HIV treatment, in which a limited number of drug combinations is used for all patients in South African programs, works just as well as the highly individualized approach to drug selection used in Switzerland, according to research published in PLoS Medicine.

Researchers based at University of Bern, Switzerland and University of Cape Town, South Africa, analyzed data collected since 2001 from more than 2,000 patients enrolled in HIV treatment programs in two townships (Gugulethu and Khayelitsha) in Cape Town, South Africa, and from more than 1,000 patients enrolled in the Swiss HIV Cohort Study, a nationwide study of HIV-infected people.

Currently, approximately 3 million people with HIV in low- and middle-income countries are receiving antiretroviral therapy. The majority of treated individuals are in sub-Saharan Africa, where only about 50,000 people were being treated as recently as 5 years ago. This rapid scale-up has raised questions of whether the World Health Organization's standardized approach to treatment selection and clinical monitoring can meet with the same success as "customized" approaches used in high-income countries.

This study found the programmatic and individualized approaches to be equally successful – provided that treatment is begun early enough. The patients in South Africa started their treatment for HIV infection with one of four first-line therapies, and about a quarter changed to a second-line therapy during the study. By contrast, 36 first-line regimens were used in Switzerland, where half the patients changed to a different regimen. Despite these differences, the level of HIV in blood was greatly reduced within a year in virtually all the patients and viral rebound (an increase in viral levels following initially effective treatment) developed within 2 years in a quarter of the patients in both countries.

However, more patients died in South Africa than in Switzerland, particularly during the first 3 months of therapy. According to the researchers, this difference likely reflects the fact that patients in South Africa were more likely than patients in Switzerland to have advanced AIDS prior to starting treatment.

These findings support the continued rollout of the public-health approach to HIV treatment in resource-poor countries, and raise the possibility that a more standardized approach could be taken in developed countries without compromising treatment effectiveness. The higher mortality in South Africa compared to Switzerland suggests that many HIV-infected patients in resource-limited countries would benefit from earlier initiation of therapy.

Source: Public Library of Science

Explore further: Animal study provides first evidence that gel can prevent multiple virus transmission in vagina/rectum

add to favorites email to friend print save as pdf

Related Stories

Pocket diagnosis

Mar 19, 2014

A new app which turns any smartphone into a portable medical diagnostic device could help in the fight against diseases including HIV, tuberculosis and malaria in the developing world.

Sun powers complex cancer test for remote regions

Feb 21, 2014

From the sun, a solution: Cornell University and Weill Cornell Medical College researchers have remodeled an energy-intensive medical test – designed to detect a deadly skin cancer related to HIV infections ...

Recommended for you

HIV+ women respond well to HPV vaccine

Apr 16, 2014

HIV-positive women respond well to a vaccine against the human papillomavirus (HPV), even when their immune system is struggling, according to newly published results of an international clinical trial. The study's findings ...

User comments : 0

More news stories

Unraveling the 'black ribbon' around lung cancer

It's not uncommon these days to find a colored ribbon representing a disease. A pink ribbon is well known to signify breast cancer. But what color ribbon does one think of with lung cancer?

Classifying cognitive styles across disciplines

Educators have tried to boost learning by focusing on differences in learning styles. Management consultants tout the impact that different decision-making styles have on productivity. Various fields have ...

Tiny power plants hold promise for nuclear energy

Small underground nuclear power plants that could be cheaper to build than their behemoth counterparts may herald the future for an energy industry under intense scrutiny since the Fukushima disaster, the ...

Hand out money with my mobile? I think I'm ready

A service is soon to launch in the UK that will enable us to transfer money to other people using just their name and mobile number. Paym is being hailed as a revolution in banking because you can pay peopl ...