Effectiveness
of Combination Antiretroviral Therapy in Developing Countries
In
comparison with developing countries, there have been
relatively few studies of the long-term effectiveness of combination
antiretroviral therapy in the developing world. As
reported in the April 1, 2007 Journal of Acquired Immune Deficiency Syndromes,
researchers established an observational database at the HIV clinic of the AlmenaraHospital in Lima,
Peru in 1996. All 564 initially antiretroviral-naive
patients who received combination therapy were followed over time; in this
cohort, the mean CD4 cell count was 91 cells/mm3.
Results
The overall survival rates were:
96% at year 2;
94% at year 4;
91% at year 5.
Among patients who initiated therapy
with CD4 counts < 100 cells/mm3, the 3-year survival rate was 95%.
20% of patients developed opportunistic
infections while on antiretroviral therapy.
“This
study demonstrates the long-term effectiveness of antiretroviral therapy in a
developing country urban setting,” the authors concluded. “It provides evidence
of the importance of continuing global financing initiatives to provide widespread
HIV therapy for countries in the developing world.”
Clinical
Research Division, Fred Hutchinson Cancer Research Center, Department of Medicine,
University of Washington School of Medicine, Seattle, WA; Hospital Guillermo Almenara,
Lima, Peru; Asociacion Civil ImpactaSalud y Educacion, Lima, Peru; Duke University, Durham, NC; Bristol-Myers
Squibb Company.
04/24/07
Reference DM Corey, HW Kim, R Salazar, and others. Effectiveness of Combination Antiretroviral
Therapy on Survival and Opportunistic Infections in a Developing World Setting:
An Observational Cohort Study. JAIDS44(4): 451-455.
April 1, 2007.
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