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HIV Drugs Improve, but Not Death Rate

'HAART' Treatment Is Effective, but Many Patients Are Now Sicker When They First Get Treated
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WebMD Health News
Reviewed by Louise Chang, MD

Aug. 3, 2006 -- Ten years after the introduction of highly active antiretroviral therapy (HAART), HIV treatment continues to improve, with today's drug regimens eliciting better viral control than those of the past with far fewer serious side effects.

Yet despite the steady evolution of HIV therapy, a newly released study shows no corresponding decline in death rates or progression to AIDS among patients from North America and Europe who were followed for up to a year.

Just over 22,000 patients starting therapy for the first time were included in the study, which appears tomorrow in the journal The Lancet.

The findings do not mean that HAART is not saving lives or keeping HIV-infected people from developing AIDS.

All agree that today's drug regimens are remarkably effective. So effective, in fact, that one study found the nine out of 10 patients who stay on the treatment can expect to live for more than a decade.

Rather, the findings seem to reflect the changing face of HIV infection in Europe and North America, experts say.

Changing Demographics

Researchers found that in 2003, patients tended to be sicker when they started treatment than those beginning treatment in 1995. And that the number of AIDS cases seen in recent years is related to an increase in cases of tuberculosis.

Compared with patients starting HAART for the first time in 1995, those starting therapy in 2003 were far more likely to be female and infected with HIV through heterosexual rather than homosexual contact.

Specifically:

  • The percentage of female patients starting therapy increased from 16% in 1995-1996 to 32% by 2002-2003.
  • During the same period, the percentage of men who became infected through sexual contact with men declined from 56% to 34%.
  • The percentage of patients presumed to have become infected via heterosexual contact increased from 20% in 1995-1996 to 47% in 2002-2003.
  • The percentage of patients infected via injected drug use declined from 20% in 1997 to 9% in 2002-2003.

The study suggests that homosexual men have benefited the most from HAART. The best viral responses to therapy have been seen among this group, while women and men infected via heterosexual contact have not benefited as much.

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