Combined therapies halve Aids deaths

A SIMPLE change in the treatment given to patients with the Aids virus has been shown to halve their risk of death, according…

A SIMPLE change in the treatment given to patients with the Aids virus has been shown to halve their risk of death, according to findings in an Irish-US led study released yesterday.

Patients with the virus, HIV, often pick up opportunistic infections such as pneumonia or meningitis.

Death rates can be cut by half if these patients receive a combined rather than individual treatment for their opportunistic and HIV infections, according to the study’s senior author, Prof William Powderly of University College Dublin.

Details of the study were released in the online journal PloS-One, published by the Public Library of Science.

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It was jointly led by UCD and by Stanford University, California, with contributions from researchers in other US centres and from South Africa.

Increasing numbers of patients with HIV are presenting late for initial treatment, often after they have acquired opportunistic infections, according to Prof Powderly, dean of medicine in UCD’s school of medicine and senior author of the report.

Clinicians hesitated giving them anti-retroviral HIV drugs along with treatments for their secondary infections for fear that the two treatments would interfere with one another, he said.

A study of these risks by the Aids Clinical Trials Group involving 282 patients in the US and South Africa showed, however, that those receiving combined therapies did much better and had a 50 per cent lower risk of death than those who received individual treatments.

“If we are more aggressive with HIV drugs we can reduce Aids-related complications and death by 50 per cent,” stated Dr Andrew Zolopa of Stanford University school of medicine and first author of the report.

“The results of this study will change practices throughout the world,” according to Dr Mitch Katz, San Francisco’s director of health, commenting on the findings.

“This study shows that it is life-saving to treat those persons with anti-retroviral drugs while they are still in the hospital.”

The findings have already begun to change clinical practice across the globe.

The International Aids Society, the US Centres for Disease Control and Prevention and the British Aids Society have all adopted new guidelines recommending early anti-retroviral treatments.

“Early anti-retroviral treatment for HIV improves the clinical outcome, including the likelihood of surviving in the next few months,” Prof Powderly said.

“It probably does so by rapidly improving the immune system and therefore adds to the ability to resist these infections.”

Dick Ahlstrom

Dick Ahlstrom

Dick Ahlstrom, a contributor to The Irish Times, is the newspaper's former Science Editor.