adminWITH new efficacious drugs for tuberculosis and HIV co-infection, the success rate in treatment and care can record an upward trend. This was shown by the studies carried out for HIV-TB infection, care and treatment. The largest randomised controlled study ever to see the effect of early initiation of Anti Retroviral Therapy (ART) named Strategic Timing of Anti Retroviral Treatment (START) has confirmed the effect of early ART initiation.
The study’s objective was to assess early ART initiation benefits and assess if serious health complications we averted as compared to initiation when a patient’s CD4 count fell to 350 cells/mm3.
The study, conducted by the US National Institute of Allergy and Infectious Diseases (NIAID) and US National Institute of Health (NIH), brings new insight into the role timing plays in treating HIV. The trial study assessed a group of 4,685 asymptomatic HIV-positive patients from 215 sites in 35 geographically diverse countries.
All participants had never taken anti retroviral therapy (ART) and all had CD4+ T-cell counts above 500 cells/mm3 — a measure of immune system health.
The most common Aids-related illnesses among study participants were pulmonary tuberculosis, Kaposi’s sarcoma, and non-Hodgkins lymphoma.
According to the NIH, “…over an average follow-up of three years, the risk of Aids, and other serious illnesses or death was reduced by 53 percent among those in the early treatment group compared to those in the deferred treatment group.”
Moreover, it was found that only 41 instances of Aids, serious non-Aids illness or death occurred among those enrolled in the study’s early treatment group compared to 86 such events in the deferred treatment group.
The main drugs used locally in treating tuberculosis are rifampicin and isoniazid.
Locally patients report to hospitals when they are bedridden and when put on medication it appears the medication makes them worse which is not true because they would have wasted away.
In such cases doctors may decide to treat TB first before placing one on ARVs as the complex medicine regimens may be too much for a patient all at once.
“We may place a patient on TB treatment first if they are in poor shape and then introduce ART as they improve,” said Dr Owen Mugurungi, director in Aids and TB Unit in the Ministry of Health and Child Care.
A study, TEMPRANO ANRS Trial on anti-retrovirals and isoniazid preventive Therapy in Africa, selected sub-Saharan Africa, which is heavily burdened with TB-HIV infection.
A total of 2 056 patients with a baseline of CD+Count of over 500 cells/mm3 also confirmed that early ART initiation averted a host of other opportunistic infectious diseases.
The study showed that the risk of severe HIV-related illness was 44 percent lower and a risk of death from any cause that was 35 percent lower than the risk with deferred initiation of ART.
The World Health Organisation (WHO) and its partners and supports the option of “Test and Treat” — or the hypothesis that taking HIV drugs radically reduces a person’s risk of transmission and, therefore, as more and more people are put on medication, the epidemic should end itself.
Online Reporter