Good News For Co-Infected AIDS Patients

It is a bold step, but the signs are that it is a breakthrough in the ongoing battle to stop the death march of HIV/Aids.That is the message from researchers at Durban's Doris Duke Medical Research Institute, who believe they have found the key to treating thousands of South Africans co-infected with tuberculosis and HIV.

A clinical trial integrated the HIV and TB treatment, a joint strategy which, until now, was not implemented adequately in a clinical setting because of concerns about drug compatibility and toxicity. Initial trial results show that by combining treatment the death rate can be reduced by 55 percent. The results are so significant that an independent safety monitoring committee has recommended that patients enrolled in the sequential treatment arm of the trial (where patients were prescribed antiretrovirals only after completing their TB treatment) should be initiated on ARVs as early as possible, so that they, too, can benefit from the combined treatment.

Explaining the background to the trial, Prof Salim Abdool Karim - the trial's principal investigator and director of the Centre for the Aids Programme of Research in South Africa (Caprisa) - said that from the data, it was clear that the two diseases needed to be treated jointly."There are many challenges in treating both conditions simultaneously. As a result, integration of TB and Aids treatment has not been as widely implemented as we would like. This study's findings make a compelling case for greater linkages between TB and Aids services."Implementing an integrated TB and HIV treatment program in South Africa could, he says, prevent about 10 000 deaths a year and lead to an additional 100 000 to 150 000 patients (with TB and a CD4 cell count of less than 500) being given life-saving medication.

The next step, once the optimum integration treatment strategy is established, will be to urge the health sectors nationally and internationally to actively promote integrated TB-HIV treatment as standard practice.

More than 350 000 people in South Africa are infected with TB, of which 70 percent are believed to be co-infected with HIV.The groundbreaking trial involved 645 men and women 18 years or older with smear-positive pulmonary TB and HIV infection, with a CD4 count of less than 500. Courtesy Independent Online of South Africa