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Start HIV Drug Treatment Early in Patients With TB: Studies
Date:10/19/2011

By Randy Dotinga
HealthDay Reporter

WEDNESDAY, Oct. 19 (HealthDay News) -- Three new studies provide insight into the best time to begin AIDS drug treatments in HIV-positive patients who are also infected with tuberculosis, a double whammy common in Africa. Starting the drugs earlier, even by a few weeks, could make a big difference for patients who are very sick, the research suggests.

The cost of earlier treatment isn't much higher, and the drugs pay big dividends, said Dr. Diane V. Havlir, lead author of one of the studies. Her study found that starting the drugs within two weeks of diagnosis rather than eight weeks reduced the death rate or progression to more severe HIV by almost 40 percent in the sickest patients.

"This is fabulous news. It's amazing that starting it at two weeks versus eight weeks makes such a difference," said Havlir, professor of medicine at the University of California, San Francisco, and head of the AIDS division at San Francisco General Hospital.

HIV, the virus that causes AIDS, and tuberculosis frequently strike people in less developed regions such as sub-Saharan Africa, Havlir said. HIV disrupts the immune system, she said, making it easier for people to get tuberculosis.

"These two diseases go hand in hand," she said. "They're synergetic, they're partners."

The studies are published in the Oct. 20 issue of the New England Journal of Medicine.

The HIV-tuberculosis combo is less common in richer areas of the world, such as the West, said Dr. Jeremy Farrar, co-author of a commentary accompanying the studies. He is director of the Oxford University Clinical Research Unit in Ho Chi Minh City, Vietnam.

It hasn't been clear how to treat patients who have both diseases. Among other things, doctors worried about adding HIV drugs to tuberculosis drugs because of concerns about side effects, including those from drug interactions, Havlir said.

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