Youth Awareness Movement Against AIDS In Africa.
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Clinical Symptoms Enough to Switch Drug Regimens for HIV Patients
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.
Dr. Michael Horberg, director of HIV/AIDS policy at Kaiser Permanente Health Plan in Santa Clara, California said "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. 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."
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.
Dr. Michael Horberg, director of HIV/AIDS policy at Kaiser Permanente Health Plan in Santa Clara, California said "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. 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."
Source: The Washington Post
Last updated by YAMAA May. 4, 2008.
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