Important note: Information in this article was accurate in 2003. The state of the art may have changed since the publication date.

Reuters NewMedia - Thursday October 16, 2003
Patricia Reaney

The introduction of life-saving drug combinations known as Highly Active Antiretroviral Therapy (HAART) in 1997 means AIDS is no longer an automatic death sentence.

Death rates were halved shortly after the drug cocktails became available and declined by over 80 percent by 2001.

"Nine out of 10 people could expect to live for 10 years regardless of the age at which they became infected. We haven't reached the medium yet so it could be 17 or 20 years -- we can't really say at the moment," said Dr Kholoud Porter, of Britain's Medical Research Council (MRC).

Before HAART, only about half of people infected would have expected to be alive 10 years later and even fewer if they were more than 40 years old when they were infected.

Ageism no longer seems to be an issue because older people on HAART do not have a reduced life expectancy. But the research, reported in The Lancet medical journal, shows that injecting drug users are four times more likely to die of AIDS than men infected through sexual contact.

Porter said they are less likely to take the sometimes complicated combinations of anti-AIDS drugs properly.

Intravenous drug users are also more likely to have co-infections with other viruses, particularly hepatitis C.

"Before age mattered, now it doesn't. Before, exposure category or risk group didn't matter and now it does," Porter told Reuters.

GAP BETWEEN RICH AND POOR

While HAART has extended the lives of AIDS patients in countries where people can afford to pay, the treatment is still scarce in poor nations, despite intense pressure for pharmaceutical companies to cut prices.

Last month, drug companies said they had doubled the supply of AIDS medicine to Africa. More than 76,300 Africans were receiving cut-price drugs from six pharmaceutical firms at the end of June 2003, compared to 35,500 in March 2002.

But UNAIDS, the United Nations group spearheading the global battle against the epidemic, estimates that 4.1 million African desperately need the treatments. Thirty million of the 42 million people worldwide infected with the AIDS virus live in sub-Saharan Africa.

Porter's findings were based on an analysis of 22 different studies across Europe, Australia and Canada, where the drugs are readily available.

HAART refers to a combination of three or more medicines from at least two classes of anti-AIDS drugs. The various treatments attack the AIDS virus in different phases of its life cycle.

Porter said long-term follow-up of AIDS patients is essential because the drugs are toxic and patients are showing resistance to them.

"We hope we go on seeing survival improvements and that people infected with HIV will end up having the same survival expectations as people who are (HIV) negative," Porter added.

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