Important note: Information in this article was accurate in 2005. The state of the art may have changed since the publication date.
Associated Press - November 30, 2005
Stephanie Nano
The largest study of AIDS treatment in a developing country, released on World AIDS Day, supports the idea of expanding treatment in poor nations, the researchers said.
"There's lots of challenges, but they can be overcome," said the senior author, Dr. Daniel Fitzgerald of Cornell University's Weill Medical College in New York.
After a year of treatment at a clinic in Haiti, 87 percent of the adults and 98 percent of the children in the study were still alive, comparable to the one-year survival rate for U.S. patients, according to the researchers.
Without treatment, less than a third of AIDS patients live for a year in developing countries like Haiti, they said.
"It tells us we can do more and be more aggressive and make sure everybody gets treated, said Dr. Jean William Pape, one of the researchers and director of the clinic known as GHESKIO Center in Port-au-Prince, the Caribbean nation's capital.
Today, the clinic is providing AIDS drugs to 2,600 patients, he said.
The study appears in Thursday's New England Journal of Medicine.
Until international funding became available a few years ago, Fitzgerald said the clinic in Haiti scraped together AIDS drugs for a limited number of patients.
"The funding allowed us to treat everybody who walked in the door who needed the drugs - which was great," Fitzgerald said.
The study followed the first 1,004 AIDS patients, including 94 children, who started treatment after the new funding started in 2003. Many were sick with AIDS-related illnesses or tuberculosis, and were malnourished and poor, earning less than $1 a day.
They received a standard three-drug regimen for AIDS, plus vitamins, treatment for TB, and in some cases a supply of rice, beans and vegetable oil. They were counseled by the clinic's staff, which also made home visits.
The treatment suppressed the AIDS virus to undetectable levels in three-quarters of the patients, the researchers said. They estimated the annual cost per patient at $1,600.
"Port-au-Prince, Haiti, is one of the most challenging urban centers in the world in which to implement a major public health intervention," Dr. Jim Yong Kim and Charlie Gilks of the World Health Organization wrote in an accompanying editorial. "The results, as compared with those from settings in the United States, are truly remarkable."
At the clinic this week, Elisabeth Dumay, 42, recalled being in a state of despair when she learned she was HIV-positive. Her father and her husband had died of AIDS.
She has been on AIDS drugs since 2001 and now works at the center, counseling new AIDS patients, sharing her story and urging them to continue taking their drugs.
"I'm very proud to be a role model," Dumay said.
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Associated Press writer Alfred de Montesquiou contributed to this report from Port-au-Prince, Haiti.
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On the Net: New England Journal: http://www.nejm.org
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