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HIV mortality in India drops with introduction of generic antiretroviral therapy

The survival rate of HIV-infected patients in India has risen in response to a 20-fold drop in the price of antiretroviral therapy (ART), according to an article in the Nov. 15 issue of Clinical Infectious Diseases, now available online. The introduction of generic drugs into the country has encouraged people to seek HIV treatment because of the cheaper cost, the article states.

Many of the more than 5 million HIV-infected people living in India have been unable to obtain treatment due to the high cost. With the introduction of generic ART into India in 2000, the price of HIV drugs fell from $778 per month to $100 per month, and eventually declined even further to just $33 per month in 2003.

The drastically lower cost of ART sparked a rise in the number of people seeking--and obtaining--treatment for their infection. Researchers in India and Rhode Island found that in 1996, just 13 percent of the Indian patients who qualified for ART were able to afford it. But that number rose to 22 percent in 2000, and reached 44 percent in 2003.

With the availability of much-needed drugs came better health. Opportunistic infections such as tuberculosis, a common problem for immunocompromised patients, occur at a much lower rate in those receiving ART and its highly active drug counterpart, HAART. Accessible drugs have led, in part, to an 80 percent decline in HIV-related deaths in India between 1997 and 2003.

Despite ART's importance in improving HIV-infected people's health, it can also cause problems. Adverse events, such as rash, nausea, diarrhea, headache and anemia, can arise from antiretroviral use. But are the side effects serious enough to discourage patients from continuing ART? "No. Benefits of HAART outweigh the toxicities, based on our experience in our patients," said lead author Nagalingeswaran Kumarasamy, PhD, of the YRG Centre for AIDS Research and Education in Chennai.

Along with the much cheaper price of ART--which can be expected to drop even further, said Dr. Kumarasamy--comes further encouragement for Indian HIV patients to seek treatment. "Voluntary counseling centers are being set up in public hospitals and in centers where persons with high risk for HIV seek medical attention," Dr. Kumarasamy said. Such centers offer pre- and post-test counseling, which includes medical counseling on HIV care, like ART. Making HIV-infected people aware of affordable treatment options is an important additional step toward curbing the spread of a deadly disease in a resource-poor country.


Source:Infectious Diseases Society of America

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