Thursday, August 7, 2008
Drugs add 13 years to average life of HIV patient
Cocktails of HIV drugs help patients live an average of 13 years longer — if they are lucky enough to get them, researchers reported.A person who started taking the drugs at age 20 could, on average, expect to live another 43 years, the researchers report in the Lancet medical journal.They looked at several studies of patients living in the United States, Canada and several European countries who received drug combinations known as highly active antiretroviral therapy or HAART.Robert Hogg of the British Columbia Centre for Excellence in HIV/AIDS in Vancouver, Canada and colleagues looked at 43,000 patients in 14 different studies."Between 1996-99 and 2003-05, there was a gain in life expectancy for those at age 20 years of about 13 years; similar gains in life expectancy in those aged 35 years were also seen," they wrote."A person starting combination therapy can expect to live about 43 years at 20 years of age, about two-thirds as long as the general population in these countries." Average life expectancy for a 20-year-old without HIV in those countries would be 80, they said.Patients treated later on in their infections and those infected via injected drug use did not live as long as those treated early, the researchers found.Near-normal lifeThere is no vaccine and no cure but the drugs can suppress the virus and allow patients to lead a near-normal life. Without treatment, the virus destroys the immune system, leaving patients susceptible to infections and cancer.More than 20 drugs are now on the market and can be combined in various ways to control the virus, although it usually mutates eventually and patients must switch to different regimens to keep it under control.Drug companies have come up with combination pills to make it easier to stay on therapy.Nearly 3 million people in the developing world now get HIV drugs — about 70 percent of those who need them, according to the United Nations.Makers include GlaxoSmithKline, which helped pay for the Lancet study, Gilead Sciences Inc, Roche, Pfizer, Merck Inc, Bristol-Myers Squibb and Abbott Laboratories.HIV is passed through sex, blood, injected drug use and from mother to child at birth or through breast milk.In a second study in Lancet, Robert Bollinger of Johns Hopkins University in Baltimore and an international team of colleagues found that giving the HIV drug nevirapine daily to breastfed infants up to six weeks of age could protect them.A study of nearly 1,900 infants showed that giving them the drug for weeks, instead of simply dosing the mother while in labor and the baby shortly after birth, reduced infection rates by 46 percent.Doctors believe the benefits of breastfeeding outweigh the risks in poor countries where it is difficult to obtain clean water or infant formula."Extended infant prophylaxis with nevirapine is simple enough to be implemented almost anywhere," Dr. Jeffrey Stringer and Dr. Benjamin Chi of the University of Alabama at Birmingham, wrote in a commentary."It represents a long-awaited, if partial, solution to a mother's impossible choice. We should not delay.”
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