The U.S. federal government plans to spend in this financial year $21 billion for HIV/AIDS research, treatment, prevention, and related activities. Among doubts on whether this enormous expenditure is paying off, a new study was conducted which seemingly indicated that the expenditure is paying off and is more successful than of what was previously thought. The study that is now available on line is due to be published in the JULY edition of The Journal of Infectious Diseases, Rochelle P. Walensky, MD, MPH, Kenneth Freedberg , MD, MSc and colleagues at Massachusetts General Hospital and other centers, conducted the study, which appears at a time the world is contemplating the 25-year anniversary of the first reported cases of AIDS and celebrating the 10-year anniversary of the use of multi-drug antiretroviral combinations for the treatment of HIV infections (also known as highly active antiretroviral therapy or HAART).
To analyze the impact of HAART on patient survival, the investigators used a computer simulation model to examine national surveillance and efficacy data for newly diagnosed adult AIDS patients under care in the United States from 1989 to 2003. They divided those years into 'eras' corresponding to specific advances in AIDS care, and then used the simulation model to determine per-person survival time for each era, compared to the absence of treatment.
In an accompanying editorial, Sten H. Vermund, MD, PhD, of Vanderbilt University observed that the benefits of HAART suggested by this study are greater than previously thought and may become still greater if certain barriers to care can be reduced or eliminated--such as the requirement for 'extensive, expensive, time-consuming and intimidating' pre-test counseling for HIV infection. "If we address systematically the barriers to testing, care, and prevention,' he concluded, 'then future modelers will describe the next 15-year period as having saved hundreds of millions of life-years, not just in North America but around the globe.'