Cocktail of drugs could prevent 10,000 HIV deaths a year, claim scientists

A package of low-cost drugs designed to prevent deadly infections among people who are starting HIV treatment late could save 10,000 lives a year across sub-Saharan Africa, scientists believe.

About one in five people who start HIV treatment in poorer countries are doing so later than advisable, which means they have a low number of CD4 cells, a key component of the immune system. This leaves them far more vulnerable to developing serious illnesses. Roughly one in 10 such people die within the first few weeks of treatment because their immune systems cannot recover fast enough.

HIV prevalence is particularly high in sub-Saharan Africa, with womenand children especially vulnerable, but a study led by academics at University College London found that a preventative package of anti-infection drugs significantly reduces the number of deaths from HIV-related illnesses. The researchers estimate that if the drugs were given to every patient in sub-Saharan Africa starting anti-HIV treatment and suffering from a low CD4 count, the drugs could prevent roughly 10,000 deaths each year.

Six months after starting this regimen, the mortality rate among patients fell. Almost 9% of patients taking the drug combination died, compared with 12% who didn’t take them. The drugs bundle also reduced illnesses including TB, cryptococcal disease, a potentially fatal fungal infection, and candida disease, a fungal condition.

Diana Gibb, professor of epidemiology at UCL’s medical research council clinical trials, said the package of drugs will help the large number of people who do not realise they have HIV until the later stages, or who do not seek treatment due to stigma.

The package is cheap and cost effective, she added. Across all countries involved in the trial, the bundle was roughly £4 more expensive than the standard co-trimoxazole drug given to people starting HIV treatment. By combining some of the drugs into a fixed-dose tablet, academics also ensured that, for most of the 12 weeks, participants were only required to take one extra tablet a day.

The study, which was funded by the Medical Research Council, the UK Department for International Development and the Wellcome Trust, recommended the CD4 test for all people receiving HIV treatment. The researchers said the enhanced package of drugs should become standard for people who have low CD4 counts and start treatment late.

The WHO will decide whether to adopt the treatment over the coming year.

On 20 July, the UN programmes on HIV and Aids reported that 53% of all people living with HIV now had access to treatment – 19.5 million out of 36.7 million. If progress continues at this pace, UNAids said the world would be on track to hit the global target of reaching 30 million people with treatment by 2020.

Source: The Guardian