Thousands More Could Be Treated For HIV In Africa If Expensive Routine Lab Tests Are Dropped

A third more people could be successfully treated for HIV in Africa if expensive lab tests, routinely used for monitoring side effects, are abandoned, according to the ‘Development of Anti-Retroviral Therapy in Africa (DART)’ clinical trial funded by the Medical Research Council and co-run at Imperial College London.
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Anti-retroviral treatment (ART) is the main type of treatment for HIV or AIDS and involves patients taking drugs every day for the rest of their lives. It is not a cure, but it can stop people from becoming ill for many years. The aim of ART is to keep the amount of HIV in the body at a low level. This helps to stop any weakening of the immune system and allows it to recover from any damage that HIV might have caused already.

In the biggest trial of HIV therapy to date in Africa, published today in The Lancet, 3,316 people who had not previously had ART took part. All had severe or advanced HIV infection and had been assessed for ART eligibility using clinical staging and laboratory tests including CD4 cell count (a measure of how well the body’s immune system, which is damaged by HIV, is working). The trial began six years ago in Uganda and Zimbabwe when treatment for people with HIV was starting to become more widely available. The report concluded that ART can be delivered safely, without routine laboratory monitoring for toxic effects, but differences in the progression of the disease suggested monitoring CD4-cell count from the second year of treatment. The survival rate in the DART trial is amongst the best reported from any trial, ART programme or study in Africa.

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