Good news for those attempting to extend antiretroviral treatment to the many millions of people with HIV in developing countries who need medicines but do not receive them.
An extensive study over six years in Uganda and Zimbabwe supported by the UK’s Medical Research Council in Africa suggests that up to a third more patients could be offered treatment, even given existing stretched domestic resources, thanks to a simple trade-off.
The Dart study, published in the latest issue of the Lancet, suggests that regular laboratory monitoring for toxic effects is costly and unnecessary, diverting funds that could instead be used to provide more drugs to patients at an earlier point in the development of the disease.
The researchers, led by Diana Gibb, argue CD4 testing, to measure the breakdown of the body’s immune response, should take place after two years’ treatment to determine whether to switch to more expensive “second-line” therapies.
Margaret McCartney
Clive Cookson
Andrew Jack