[afro-nets] HIV Treatment Programs Efficacy in Poor Countries

[Leela McCullough <leela@healthnet.org>]

HIV Treatment Programs in Poor Countries as Effective as in De-
veloped Countries
---------------------------------------------------------------

10 June 2005

Antiretroviral therapy (ART) programs for treating HIV in devel-
oping countries are about as effective as ART programs in devel-
oped countries, according to an article in the July 15 issue of
Clinical Infectious Diseases, now available on-line.

Some have raised doubts that countries with extremely limited
health care resources can effectively manage the complexities of
antiretroviral therapy. But the new review of 10 medical studies
on HIV treatment programs in the developing world showed that
about 57 percent of patients had an undetectable level of HIV in
their blood one year after starting ART, which is comparable to
that in the developed world.

Availability and cost of ART medications are often barriers to
treatment of HIV-infected people in countries lacking resources.
Some countries, like Botswana, have government-funded ART pro-
grams that provide free or low-cost treatment to those in need.
The article found that cost of medication was a significant fac-
tor--six months after ART initiation, nearly 30 percent more pa-
tients had undetectable viral levels when they received the
drugs at no cost than did those who had to pay.

Lead author Louise Ivers, MD, of Harvard Medical School, was not
surprised by the similarities in ART's efficacy in poorer coun-
tries to that in industrial nations. "People in developing coun-
tries have just as much incentive to get well as in rich coun-
tries," she said, adding that, if ART is free, patients' adher-
ence to medication is good. However, "in most poor countries the
cost of antiretrovirals is really prohibitive" and "even people
who can afford it for a few months may not be able to afford it
in the long term," said Dr. Ivers. "This shows that we have to
try to find a way to provide free antiretrovirals." She hopes
that the results showing a link between free ART and successful
treatment of HIV will encourage governments in resource-limited
countries to fund antiretroviral clinics for those in need.

All studies included in the review had to meet certain criteria,
such as having only adult HIV patients, in order to effectively
compare them with each other. Dr. Ivers, who works with HIV-
infected patients in Haiti, believes the article's findings
would be the same regardless of how many studies were included.
"We actually looked at hundreds of studies," Dr. Ivers said, but
only selected "the ones that might meet the rich countries'
definition of antiretroviral success." However, many of the
smaller studies not included "gave narrative descriptions of pa-
tients that had done well or gained weight" due to antiretrovi-
ral use.

An accompanying editorial by Carlos del Rio, MD, and Frances
Priddy, MD, of Emory University, echoed Dr. Ivers' sentiments
and emphasized that "as substantial resources become available
for treatment in resource-poor countries we must not allow fund-
ing for prevention to diminish."

Founded in 1979, Clinical Infectious Diseases publishes clinical
articles twice monthly in a variety of areas of infectious dis-
ease, and is one of the most highly regarded journals in this
specialty. It is published under the auspices of the Infectious
Diseases Society of America (IDSA). Based in Alexandria, Vir-
ginia, IDSA is a professional society representing more than
8,000 physicians and scientists who specialize in infectious
diseases. Nested within the IDSA, the HIV Medicine Association
(HIVMA) is the professional home for more than 2,700 physicians,
scientists and other health care professionals dedicated to the
field of HIV/AIDS. HIVMA promotes quality in HIV care and advo-
cates policies that ensure a comprehensive and humane response
to the AIDS pandemic informed by science and social justice.
For more information, visit http://www.idsociety.org.


--
Leela McCullough, Ed.D.
Director of Information Services

SATELLIFE
30 California Street, Watertown, MA 02472, USA
Tel: +1-617-926-9400
Fax: +1-617-926-1212
mailto:leela@healthnet.org
http://www.healthnet.org


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30 Years GTZ. Partner for the Future. Worldwide.
GTZ Spotlight 2005: Focus - Fascination - Future: Designing tomorrow's cities. http://www.gtz.de/spotlight