AIDSWEEKLY Plus; Monday, July 31, 2000
Prepared by AIDS Weekly editors from staff and other reports

NewsRx -- Highly active antiretroviral therapy has been attributed to a decline in AIDS-defining illnesses in Europe during the period 1994-1998.

During 1996 and 1997, highly active antiretroviral therapy (HAART) was introduced to treat HIV-1-infected patients who had low CD4-cell counts. In the July 22, 2000, issue of Lancet 2000 Jul 22;356(9226):291-6, A. Mocroft and colleagues report findings from the EuroSIDA study, which looked at the change in incidence of AIDS-defining illnesses (ADIs) since the introduction of HAART.

They found that the incidence of ADIs declined from 30.7 per 100 patient-years of observation, to 2.5 per 100 patient-years between 1994 and 1998, and that patients on HAART had a lower rate of ADIs than patients not on HAART.

However, although the incidence of ADIs overall declined over this period, the proportion of non-Hodgkin lymphoma increased from 4% to 16%.

The investigators conclude that these findings give strong evidence for the efficacy of HAART regimens in lowering the incidence of ADIs, but that long-term follow-up is essential to monitor the occurrence of new ADIs that may arise as a result of HAART.

Principal investigator, Jens Lundgren, comments: "Although our findings support a prolonged clinical durability of HAART, they also underline how little we know about the longer-term outcomes of this therapy. New patterns of disease, resistance, and late-onset side effects may indeed hamper the ability of HAART to work for extended periods of time. Only the future will tell us this."

He told The Lancet: "The evaluation of effect and toxicity of most of the anti-HIV drugs and combinations over the last four years has been based on short-term randomized trials, with follow-up of up to 48 weeks of limited numbers of patients. Observational studies like EuroSIDA is the only source of information on the longer-term clinical benefits of HAART."

Dr. Jens D. Lundgren, director of Copenhagen HIV Programme, can be contacted at the Department of Infectious Diseases, Hvidovre University Hospital, 2650 Hvidovre, Copenhagen, Denmark. Tel: +45 36 32 30 15; fax: +45 36 47 33 40; e-mail: j.d.lundgren@inet.uni2.dk.

This article was prepared by AIDS Weekly editors from staff and other reports.

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