Important note: Information in this article was accurate in August 2001. The state of the art may have changed since the publication date.AIDSWEEKLY Plus; Monday, August 20 & 27, 2001
Michael Greer, Staff Medical Writer
NewsRx - Researchers in the United States have shown that highly active antiretroviral therapy (HAART) reduces the risk of AIDS-related complications and death, even for patients in the advanced stages of the illness.
"Mortality and morbidity related to AIDS have decreased among HIV infected patients taking highly active antiretroviral therapy (HAART), but previous studies may have been confounded by other changes in treatment," according to Dr. Edward L. Murphy and colleagues at the University of California, the University of Washington, Brown, Georgetown, and Ohio State Universities, New York's Mt. Sinai Medical Center, the New England Research Institutes in Watertown, Massachusetts, and the National Heart, Lung and Blood Institute in Bethesda, Maryland.
Murphy and team confirmed that HAART was at least an independent factor in the markedly reduced morbidity and mortality rates seen since its introduction in the mid-1990s.
The researchers examined data from 528 patients participating in the Viral Activation Transfusion Study (VATS). All of the patients studied were infected with both HIV and cytomegalovirus (CMV) and were undergoing their first red blood cell transfusion for anemia treatment, according to the report.
Patients treated with HAART had an overall mortality rate of 0.24 deaths per person-year, study data showed, with a non-CMV disease rate of 0.15 per person-year. By contrast, the mortality rate for non-HAART-treated patients was 0.88 deaths per person-year (P< 0.001, even after adjusting for confounding variables), and such patients had a non-CMV morbidity rate of 0.45 per person-year (P< 0.05). Similar results were seen even in patients with extremely low numbers of CD4 cells, a sign of advanced illness, Murphy and coworkers noted.
While the rate of CMV disease development was also lower in HAART-treated patients, the reduction was not statistically significant ("Highly active antiretroviral therapy decreases mortality and morbidity in patients with advanced HIV disease," Ann Intern Med 2001 Jul 3;135(1):17-26.
"The data support an independent reduction in mortality and opportunistic events attributable to HAART, even in patients with very advanced HIV disease," Murphy and coauthors concluded. "However, patients with CMV infection or disease may not have a reduction in new CMV events due to HAART."
The corresponding author for this report is Edward L. Murphy, MD, MPH, Dept. of Laboratory Medicine, University of California, San Francisco, Box 0884, San Francisco, CA 94143. E-mail: murphy@itsa.ucsf.edu.
A search at www.NewsRx.net using the search term "AIDS and HIV therapy" yielded 1,191 articles in six specialized reports.
Key points reported in this study include:
This article was prepared by AIDS Weekly editors from staff and other reports.
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