Doctors' HIV treatments nearly as effective as advanced therapies – UN

Treatment of HIV-infected people by doctors looking for simple signs of deteriorating health – such as weight loss or fever – are almost as effective as those relying on advanced laboratory tests, a new United Nations-backed paper has found.

“The results of this study should reassure clinicians in Africa and Asia, who are treating literally millions of people without these laboratory tests, that they are not compromising patient safety,” said Charles Gilks, Coordinator of Anti-retroviral Treatment (ART) and HIV Care at the UN World Health Organization (WHO) and co-author of the paper published today in The Lancet.

“In fact, the outcome of their treatment is almost as good as those patients in the USA and Europe where laboratory-guided treatment is the norm.”

The study, carried out by United Kingdom experts working with WHO scientists, sought to assess the medium- and long-term consequences of the approaches to monitoring ART in settings where resources are limited.

It found that survival rates for those who were treated through clinical symptoms alone were almost identical to those who experienced laboratory monitoring. Although the survival rate is slightly higher for those living with HIV who were monitored for viral loads, the authors noted that this is not the most cost-effective strategy for the poorest countries.

Also, it was found that clinical observation alone is almost as effective as expensive laboratory tests in ascertaining when to have patients switch from WHO-recommended first-line treatments to more costly second-line medicines.

The study's authors used mathematical models and not on real patients. Very little real world data is available because ART drugs have only been used for a short time in some countries.