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HIV Survival Improves If Patients Stay in Care

People with HIV who drop out of care do not live as long as those who remain under a doctor's treatment, said Baylor College of Medicine and Veterans Affairs researchers in a report published in the June 1 issue of Clinical Infectious Diseases and available on line.

"In an era when highly active therapy directed against HIV (the human immunodeficiency virus that causes AIDS) is keeping people alive, understanding the value of regular medical care is crucial," said Dr. Thomas Giordano, assistant professor of medicine infectious diseases at BCM and lead author of the report.

"We know that adherence to medications is critically important," said Giordano. "Patients who have trouble taking their medicines regularly will do less well. But what about those people who aren't even seeing a doctor regularly" Before this study, we had only a vague understanding of the magnitude of the problem, and we certainly didn't know whether it affected survival."

While HIV is now a chronic or lifelong disease, it is one that typically strikes at a relatively young age. That makes the population different from those who have high blood pressure or adult-onset diabetes.

"These patients often have a lot of other things going on. They are young. Often, they face challenges of substance abuse, mental health problems and financial issues. Now they have to stay in care the rest of their lives, which may be 20, 30, 40 or more years."

Giordano's study, carried out in the Veterans Affairs population, determined that staying in care made a difference to longevity. Studying those in the VA population eliminated the issue of ability to pay for care, enabling him and his colleagues to look at care alone.

Giordano and his colleagues looked at 2,619 men with HIV for more than four years. Most were diagnosed between 1997-1998 at a VA hospital or clinic and began treatment after Jan. 1, 1997.

Researchers di
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