Featured Research

from universities, journals, and other organizations

Declining National Rates Of HIV-Related Deaths And Illnesses Due To Combination Antiretroviral Therapy With Protease Inhibitors

Date:
March 26, 1998
Source:
Northwestern University
Summary:
New research shows that aggressive combination antiretroviral therapy -- specifically including protease inhibitors -- dramatically reduces death rates and opportunistic infections in HIV-infected patients.

CHICAGO --- HIV-associated deaths and illnesses recently were reported to be on the decline. This was presumed to be due to improved care, including the availability of new and more potent antiviral drugs and widespread use of viral load testing to better gauge the effectiveness of these therapies. However, precise information as to the extent to which antiviral medication in general, and type of antiviral combination regimens specifically, may have contributed to the observed decrease has been unclear.

An article published in the March 26 issue of the New England Journal of Medicine shows that aggressive combination antiretroviral therapy -- specifically including protease inhibitors -- dramatically reduces death rates and opportunistic infections in HIV-infected patients.

The nationwide study described in the article found that the number HIV-related deaths decreased from almost 30 per 100 person-years in 1994 to about 9 per 100 person-years by mid-1997. At around the same time, prescription rates of combination antiretroviral therapy increased from 25 percent of patients seen in 1994 to 94 percent by June 1997, with dramatic increases noted in prescription of combination regimens including protease inhibitors from 2 percent in mid-1995 to 82 percent by June 1997.

Similarly, incidence of three major opportunistic infections, Pneumocystis carinii pneumonia, Mycobacterium avium complex and cytomegalovirus retinitis, declined from 22 cases per 100 person-years overall in 1994 to 3.7 cases for 100 person years by mid-1997.

"Changing patterns of antiretroviral treatment have reduced the morbidity and mortality of HIV-infected patients," said infectious disease specialist Frank J. Palella, M.D., of Northwestern University Medical School.

"Specifically, combination antiretroviral therapy accounted for the largest proportion of such reductions," he said.

Reductions in death and disease were clearly linked to the increasing use of combination antiretroviral therapy, with the most dramatic decline coinciding with growing use of protease inhibitors, Palella said.

"Our data suggest that intensive combination therapy including protease inhibitors should be considered the standard of care for patients with advanced HIV infection," he said.

Palella was lead author on the study, conducted in collaboration with researchers from the HIV Outpatient Study, a nationwide consortium of nine HIV clinics and research centers.

Another of the study's striking findings was that patients with private insurance were more often prescribed protease inhibitors and had lower mortality rates than those on Medicare/Medicaid. However, Palella noted that use of protease inhibitors in the period from 1994 to mid-1997 had increased markedly for both those with private and publicly funded health care.

Protease inhibitor use did not differ significantly when patients were grouped by gender, race or age, although injection drug users were slightly less likely to receive protease inhibitors. Further, the large declines in mortality rates were seen regardless of gender, race, age or HIV transmission risk category.

The researchers analyzed data over a 42-month period from each of approximately 1,250 HIV-infected patients in each of four levels of increasing intensity of prescribed antiretroviral therapy: no antiretroviral therapy; single therapy; combination antiretroviral therapy not including a protease inhibitor; and combination therapy with a protease inhibitor. Death rates and incidence of opportunistic infection were compared by antiretroviral level, drugs prescribed to prevent opportunisitic infection, patient demographics (i.e., gender, age, ethnicity and mode of HIV acquisition), and CD4 cell count (a measure of drugs' efficacy) at first study visit, as well as method of payment (i.e., private insurance, Medicare/Medicaid, self-pay and Ryan White Care Act prescription programs). Death rates and protease inhibitor prescription rates were then analyzed by source of payment.

Palella's co-researchers on this study were Kathleen M. Delancy and Diane J. Aschman, Health Research Network of Apache Medical Systems, Inc., Chicago; Scott Holmberg, M.D., Anne C. Moorman and Glen A. Satten, Centers for Disease Control and Prevention, Atlanta, Ga.; Mark O. Loveless, M.D., Oregon Health Sciences University, Portland, Ore.; Jack Fuhrer, M.D., State University of New York, Stony Brook, N.Y.; and other HIV Outpatient Study (HOPS) Investigators.


Story Source:

The above story is based on materials provided by Northwestern University. Note: Materials may be edited for content and length.


Cite This Page:

Northwestern University. "Declining National Rates Of HIV-Related Deaths And Illnesses Due To Combination Antiretroviral Therapy With Protease Inhibitors." ScienceDaily. ScienceDaily, 26 March 1998. <www.sciencedaily.com/releases/1998/03/980326080007.htm>.
Northwestern University. (1998, March 26). Declining National Rates Of HIV-Related Deaths And Illnesses Due To Combination Antiretroviral Therapy With Protease Inhibitors. ScienceDaily. Retrieved September 22, 2014 from www.sciencedaily.com/releases/1998/03/980326080007.htm
Northwestern University. "Declining National Rates Of HIV-Related Deaths And Illnesses Due To Combination Antiretroviral Therapy With Protease Inhibitors." ScienceDaily. www.sciencedaily.com/releases/1998/03/980326080007.htm (accessed September 22, 2014).

Share This



More Health & Medicine News

Monday, September 22, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Liberia Pleads for Help to Fight Ebola

Liberia Pleads for Help to Fight Ebola

AP (Sep. 22, 2014) Liberia's finance minister is urging the international community to quickly follow through on pledges of cash to battle Ebola. Bodies are piling up in the capital Monrovia as the nation awaits more help. (Sept. 22) Video provided by AP
Powered by NewsLook.com
Ebola Doctor Says Border Controls Critical

Ebola Doctor Says Border Controls Critical

AP (Sep. 22, 2014) A Florida doctor who helped fight the expanding Ebola outbreak in West Africa says the disease can be stopped, but only if nations quickly step up their response and make border control a priority. (Sept. 22) Video provided by AP
Powered by NewsLook.com
Global Ebola Aid Increasing But Critics Say It's Late

Global Ebola Aid Increasing But Critics Say It's Late

Newsy (Sep. 21, 2014) More than 100 tons of medical supplies were sent to West Africa on Saturday, but aid workers say the global response is still sluggish. Video provided by Newsy
Powered by NewsLook.com
Sierra Leone in Lockdown to Control Ebola

Sierra Leone in Lockdown to Control Ebola

AP (Sep. 21, 2014) Sierra Leone residents remained in lockdown on Saturday as part of a massive effort to confine millions of people to their homes in a bid to stem the biggest Ebola outbreak in history. (Sept. 20) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins