Important note: Information in this article was accurate in 1999. The state of the art may have changed since the publication date.
Important note: Information in this article was accurate in 1999. The state of the art may have changed since the publication date.
Reuters NewMedia - Friday March 12, 1999
In a report in The Lancet medical journal, doctors at University Hospital in Zurich said that 2,674 HIV-positive patients on highly active anti-retroviral therapy (HAART) had the lowest mortality rate recorded for such a large group. The triple drug therapy, including at least one protease inhibitor, stopped the progression of the virus and reduced the "opportunistic diseases" that attack the body because of its weakened immune state. The death rate among HAART patients dropped 1.3 percent per year.
"Our study shows that it is better to start treatment with a potent combination of at least three drugs, rather than administering different substances sequentially, one after the other," Bruno Ledergerber, who led the Swiss HIV Cohort Study, said in a statement.
HAART worked particularly well in patients who had never been treated for the disease. The amount of the virus in their blood fell to undetectable levels more often than in patients who had received other anti-AIDS drugs. Viral load is an important indicator of the likely progression of the disease.
"Even in patients affected by a viral rebound, (a resurgence of the virus in the body) the disease has not developed any more than in patients whose viral load remained undetectable, at least as far as we can tell with our current two to three years of experience," said Rainer Weber, a co-author of the report. "In other words, clinically speaking, these patients remain in reasonably good health despite an increase in viral load."
CD4 immune cells, the target cells of the HIV virus, remained high under HAART even if the replication of the virus in the body had not been stopped completely. The high level of CD4 cells allows patients to fight potentially deadly infections that afflict HIV patients.
The only downside was that doctors had to change the initial three drugs in nearly two-thirds of patients because of side effects or if viral replication was not stopped.
They achieved the best results when they replaced all the drugs at once.
Unfortunately a limited number of anti-HIV drugs could limit the number of new combinations after several years of treatment.
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