When millions of HIV-infected people in poor countries began receiving advanced drug therapies, critics worried that patient care would suffer because few high tech laboratories were available to guide treatments.
But according to a study being published in Lancet today, these concerns are as yet unfounded.
In fact, the study indicates that when clinicians use simple physical signs of deteriorating health -- such as weight loss or fever -- these doctors can provide therapies almost as effective those relying on the most advanced laboratory analysis.
"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 a co-author of the paper, Dr Charles Gilks, the coordinator of Antiretroviral Treatment (ART) and HIV Care at the World Health Organization in Geneva.
"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 aim of the study was to look at the medium and long-term consequences of different approaches to monitoring antiretroviral therapy in a resource limited setting: using clinical signs and symptoms alone as recommended in WHO guidelines; or more sophisticated and costly, but far less accessible immunological and virological load tests.
The scientists used a model that had been tried and tested in London, and shown accurately to predict the course of the epidemic in the UK over twenty years, but with various changes to reflect realities on the ground.