Professor Bill Powderly, Head of UCD School of Medicine and Medical Science
A clinical study, led by researchers from UCD and Stanford University, USA, with international collaborators, demonstrates that mortality rates of HIV patients can be almost halved when early antiretroviral (ARV) therapy is added to the treatment of AIDS-related opportunistic infections (OIs) such as pneumonia, meningitis or other serious bacterial infections.
The researchers are part of the AIDS Clinical Trials Group, the world’s largest clinical trial organisation, and their scientific findings published in PLosONE recommend changes in the treatment regimes for HIV patients worldwide.
A growing number of AIDS patients in Europe and the US are being diagnosed late in the disease process, when they have already contracted life-threatening conditions. When these patients come for treatment of these complications, doctors are often reluctant to give them anti-AIDS drugs at the same time, fearing the two therapies could interfere with one another.
Professor William Powderly , MD, dean of medicine at the UCD School of Medicine and Medical Science, and the study’s senior author, said the research addresses one of the last, longstanding unknowns in the management of AIDS. “Clinicians have long grappled with the question of whether or not early treatment with antiviral drugs will help people who come to the hospital with advanced infections, such as pneumonia.”
“The answer is clearly yes. Early antiretroviral treatment for HIV improves the clinical outcome, including the likelihood of surviving in the next few months. It probably does so by rapidly improving the immune system and therefore adds to the ability to resist these infections.”
The study could have widespread impact as an increasing number of patients in the United States and Europe, particularly injection drug users and migrants from resource-poor countries, are being first diagnosed with HIV when their disease is well-advanced, Powderly said.
“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.”
The findings, presented in abstract form at an earlier scientific meeting, are already starting to change clinical practices. The International AIDS Society, the Center for Disease Control in the US and the British AIDS Society all have adopted guidelines that recommend that early antiretroviral treatment be considered in patients with an opportunistic infection.
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