Navigation Links
Clinical Symptoms Enough to Switch Drug Regimens for HIV Patients
Date:4/24/2008

Study showed little difference in survival when compared to expensive lab tests

THURSDAY, April 24 (HealthDay News) -- Decisions on switching to a second-line series of drugs for HIV/AIDS patients who are failing the first-line regimen are often made on the basis of sophisticated and expensive lab tests.

But a new study shows that survival is only slightly affected if these decisions are based instead on the appearance of clinical symptoms.

Researchers still need to develop less expensive versions of laboratory tests currently used, but lack of test availability shouldn't affect access to highly effective drugs in poorer nations, said the authors of a study in this week's issue of The Lancet.

"I hope that the findings will reassure health policy makers and clinicians that they should continue to make every effort to widen access to ART and not allow any concerns over lack of laboratory monitoring to inhibit this," said study author Andrew Phillips, a professor of epidemiology at Royal Free and University Medical School in London.

The World Health Organization (WHO) recommends that, in lower-income areas, decisions regarding drug treatment for HIV be based on symptoms and, when available, CD4 cell count, rather than viral load.

With viral load, switches to second-line treatment occur when the viral load exceeds 500 copies per millileter.

CD4 cells are a type of immune system cell. Patients generally switch to the second-line drugs when CD4 counts in the blood drop 50 percent from their highest.

WHO-recommended first-line treatment consists of the antiretroviral drugs Zerit (stavudine), Epivir (lamivudine) and Viramune (nevirapine).

Using a computer simulation model to analyze how antiretroviral therapy influences HIV infection, the researchers compared survival rates, switch of second-line medication regimens and development of resistance for three different strategies: monitoring viral load and CD4 cell count or clinical observation.

Over a period of five years, 83 percent of patients using the viral load monitoring strategy, 82 percent using CD4 cell count monitoring, and 82 percent using clinical monitoring survived.

After a period of 20 years, survival rates were 67 percent, 64 percent and 64 percent, respectively. Viral load monitoring showed a slightly longer survival but was not the most cost-effective avenue (at a cost of around $3,500 per life-year gained).

Other experts were concerned that the results might be construed to mean viral load monitoring and CD4 cell count should be abandoned in the developed world.

"It's a great study, but it has no application to First World countries," said Dr. Michael Horberg, director of HIV/AIDS policy at Kaiser Permanente Health Plan in Santa Clara, Calif. "There is wide availability of these tests, and there should be funds to support such monitoring.

"Having said that, it has to be well-acknowledged that in resource-limited nations, CD4 count and viral load monitoring are expensive and have limited availability, and clinical decisions have to be made on the basis of clinical impressions," Horberg continued. "Health-care infrastructures must be sent to resource-limited nations. However, in the interim, clinicians should at least be reassured that their clinical practices are not doing undue harm.

"Infectivity seems to be increased with increased viral load. Not monitoring viral load could mean that highly infectious patients are passing the virus to new people and, indeed, a virus which is already resistant to drugs."

More information

The World Health Organization has more on antiretroviral therapy for HIV infection.



SOURCES: Andrew N. Phillips, Ph.D., professor, epidemiology, Royal Free and University Medical School, London; Michael Horberg, M.D., director, HIV/AIDS policy, Kaiser Permanente Health Plan, Santa Clara, Calif.; April 26, 2008, The Lancet


'/>"/>
Copyright©2008 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Cancer researchers receive NIH grant to advance brain tumor therapies from lab to clinical trials
2. Versus Technology, Inc. Announces Collaboration with Cleveland Clinic to Create Clinical Patient Flow Model
3. Welchol(TM) Added to the American College of Endocrinology/American Association of Clinical Endocrinologists Road Maps to Achieve Glycemic Control in Patients with Type 2 Diabetes Mellitus
4. Precyse Solutions Launches Clinical Documentation Improvement Program to Assist Hospitals in Accelerating Revenues
5. Clinical guidelines for the manual titration of PAP in OSA patients published in JCSM
6. Sunesis Pharmaceuticals Presents Nonclinical Data on SNS-595 at the Annual Meeting of the American Association for Cancer Research
7. Siemens New Clinical Education Training Facility Opens Doors and Expands Offerings for Imaging Professionals
8. Allegro Diagnostics Announces Publication in Cancer Prevention Research of Prediction Model for Lung Cancer Diagnosis Integrating Clinical and Genomic Features
9. Clinical Trial Volunteers Uneasy About Some Financial Ties
10. Quintiles Ranks First in Pan-European Clinical Investigator Study
11. Rejuvasun(TM) With Omnilux(TM): Industry First to Feature FDA-Cleared, Clinically Proven Light Therapy Technology
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Clinical Symptoms Enough to Switch Drug Regimens for HIV Patients
(Date:2/24/2017)... ... 2017 , ... The International Association of Eating Disorders Professionals (iaedp) announces the ... body image mannequin art competition. Selected from 15 submissions from around the nation, the ... the 31st annual iaedp Symposium, March 22 – 26 in Las Vegas. , This ...
(Date:2/24/2017)... (PRWEB) , ... February 24, 2017 , ... The ... for excellence in radiology marketing programs at the annual Building Better Radiology Marketing ... Renaissance Fort Worth Hotel in Fort Worth, Texas. Nine awards are given out in ...
(Date:2/24/2017)... Emeryville, CA (PRWEB) , ... February 24, 2017 ... ... Esparza for qualifying into the Senior International Elite division on February 12th. ... All Around divisions at the elite qualifier competition held in Las Vegas, Nevada. ...
(Date:2/23/2017)... TX (PRWEB) , ... February 23, 2017 , ... ... announced an official 2017 partnership with The Jensie Gran Fondo of Marin. For ... and UVB rays with Thinksport’s broad-spectrum, mineral-based sunscreen. , “We are thrilled to ...
(Date:2/23/2017)... (PRWEB) , ... February 23, 2017 , ... The 89th ... the winner of the 2016 National Education Policy Center Bunkum Award. We invite you ... in 2016. , This year’s Bunkum winner is the Center for American Progress (CAP), ...
Breaking Medicine News(10 mins):
(Date:2/23/2017)... Feb 23, 2017 Research and Markets has ... and Strategies - 2016" report to their offering. ... The latest research Oesophageal ... data and benchmarks in the global Oesophageal Cancer market. ... What are the key drugs marketed for Oesophageal Cancer and their ...
(Date:2/23/2017)... CITY, Calif. , Feb. 23, 2017 /PRNewswire/ ... pharmaceutical company focused on the development and commercialization ... acute pain, announced that it will release fourth ... on Thursday, March 2nd, 2017. AcelRx management will ... Eastern Time (1:30 p.m. Pacific Time) on March ...
(Date:2/23/2017)... 2017 Obese people are seldom ... varicose veins in their body. The rising number of ... adoption of endovenous laser therapy for treatment of varicose ... therapy market, published by Future Market Insights, indicates ... consequences of obesity have collectively factored the growth in ...
Breaking Medicine Technology: