23 Jun 2006

Aids drugs extend lives

Over the past 17 years, successive generations of Aids drugs have restored a total of three million years of life to HIV-positive Americans and prevented an estimated 2 900 infants from becoming infected, a new study finds.

The numbers, the first calculations of their kind, highlight both the successes and failures of Aids treatment, said study co-author A. David Paltiel, an associate professor of public health at Yale School of Medicine in New Haven, Connecticut.

On the one hand, he said, three million extra years of life is impressive. Considering the billions of dollars that have been spent on research, the research proves that "it's really worth it," Paltiel said.

Numbers could have been better
But the number could have been much higher if drugs were more widely available and more people were aware they were HIV-positive, Paltiel said. Currently, an estimated 300 000 Americans are HIV-positive but don't know it, he said.

Experts at the US Centres for Disease Control and Prevention (CDC) say their new rapid HIV-test distribution programme could help change that, however.

Reporting in the June 23 issue of their Morbidity and Mortality Weekly Report, the CDC team said 370 000 same-day tests administered nationwide between 2003 and 2005 turned up a total of 4 650 infections (1.2 percent). The advent of a one-day test - rather than the two-week wait required by older tests - should help reduce the number of Americans who are unaware they are infected with HIV, the CDC said in a prepared statement.

While early diagnosis of infection is important, the new Yale study looked at how disease treatment is helping to fight the epidemic. The researchers sought to get a better picture of the effectiveness of anti-HIV medications between 1989 - when effective drug treatment for some Aids complications became standard - and 2003.

In the mid-1990s, the biggest advances came as scientists developed powerful combinations of anti-retroviral drugs. These medication "cocktails" have allowed many HIV patients to live relatively normal lives.

The study findings appear in the July 1 issue of the Journal of Infectious Diseases.

Adds 13 years to life
According to the study's calculations, the advent of HIV-suppressing drugs added at least 2.8 million years of life to HIV patients compared to a hypothetical United States without such medications. The most recent generation of AIDS drugs will add an estimated 13.3 years to the life of each HIV-positive person who takes them, the researchers found.

In addition, drug treatment in HIV-positive pregnant women prevented nearly 2 900 infant infections, adding up to another 137 000 years of life.

And those numbers might even be higher, said study lead author Dr Rochelle Walensky, an associate director at the Harvard Centre for Aids Research in Boston. "We were actually quite strict in trying to be as conservative as possible," Walensky said.

HIV meds change lives
There's another way to look at the numbers, said Dr Sten H. Vermund, director of Vanderbilt University's Institute of Global Health and author of a commentary accompanying the study. "We have a pool of children who are not orphaned because their parents are actually alive. We have people in various roles as breadwinners who didn't leave their families without support," he said.

Modern HIV treatments can't guarantee that patients will never progress to Aids and die from complications of the disease. Resistance to drugs is a major problem, and some HIV patients are developing high cholesterol, putting them at risk of heart problems.

Still, many HIV patients are feeling perfectly healthy, said Jeff Sheehy, who's HIV-positive and advises the mayor of San Francisco on AIDS issues.

"You can virtually have a normal life, for the most part, with the very best drugs that are available today. That's astounding considering that 10 years ago, we didn't have anything, and it all hit instantly," he added. – (HealthDayNews)