Early Retroviral Use Beneficial for AIDS Patients With Serious Complications

Early retroviral use can significantly benefit AIDS patients with serious complications, suggest researchers.

Most patients don't seek medical attention until they have a serious AIDS-related condition.

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The research team from Stanford University School of Medicine showed that AIDS patients can reduce complications risk by half if they get antiretroviral treatment early on.

"This study shows that it is life-saving to treat those persons with antiretroviral drugs while they are still in the hospital. The results of this study will change practices throughout the world," said Dr Mitch Katz, San Francisco's director of health, who was not involved in the study.

Dr Andrew Zolopa, associate professor of infectious diseases and geographic medicine at Stanford and first author of the study said that growing number of the patients, particularly minorities, youth, injection-drug users and those in poor rural areas, are being diagnosed late in the disease process when they've already developed life-threatening conditions.

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"A lot of people wait, thinking, 'Let's get the patient out of acute crisis, and then we'll deal with the underlying HIV infection later,'" said Zolopa.

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"But that answer is wrong. If we're more aggressive with HIV drugs, we can reduce AIDS-related complications and death by 50 percent. It's a substantial clinical benefit," he added.

The study involved 262 patients at 39 sites across the United States, from Puerto Rico to Seattle. They all had one or more opportunistic infection, with the most common ones being pneumocystis jirovecii pneumonia, cryptococcal meningitis and serious bacterial infections.

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They found that in patients treated early, there were 20 (14.2 percent) who died or developed another significant AIDS-related complication, compared with 34 patients in the deferred group who died or suffered a new complication.

In addition, the patients in the early treatment group saw a much swifter recovery of their immune systems.

According to Zolopa, the study results probably provide some guidance for patients in developing countries, though each country would have to determine its own strategy for initiating ARVs in patients with advanced AIDS.

The study appears in the online journal PLoS-ONE.

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