BOSTON(Reuters) - Low-cost treatment can triple the AIDS survival rate in poor countries, research showed on Wednesday, defying fears that such therapy can cause complications and do more harm than good.
Malnourishment, scarce laboratory testing and the risk of complications have raised
doubt among some researchers over the value of AIDS treatment in developing regions.
"This will put to rest a lot of concerns," said Daniel Fitzgerald, author of the study of 1,004 AIDS sufferers in Haiti. The study will be published in Thursday's edition of The New England Journal of Medicine.
"The skeptics will be surprised. The people in the field who have been doing it won't be surprised," he told Reuters.
About 90 percent of the 40 million people infected with the AIDS virus worldwide live in developing countries.
Some lessons learned in the Haiti experiment "may be applicable to real tough neighborhoods in the U.S." where care for people with the AIDS virus may be sub-standard, Fitzgerald said.
Typically only 30 percent of AIDS patients survive for one year in Haiti, the poorest country in the Western Hemisphere where the HIV infection rate is about 3 percent among adults.
But integrating drug care -- usually generic drugs -- with nutritional support, tuberculosis treatment, counseling and other public health programs brought the survival rate up to 87 percent for adults and 98 percent for children, said Fitzgerald of the Weill Medical College of Cornell University.
That's comparable to the success rates in U.S. medical centers.
Most of the 1,004 patients, treated in the capital Port-au-Prince from March 2003, earned less than a dollar a day.
Fitzgerald and his colleagues said the annual cost of giving a three-drug combination to fight the AIDS virus was about $500 for generic medicines and $750 for brand-name drugs.
"We estimated the overall cost per patient per year (including medicine) as about $1,600," they said.
The "truly remarkable" result "vindicates the decision to link the treatment program with nutritional supplementation and existing social programs," said Jim Yong Kim and Charlie Gilks of the World Health Organization, in a Journal editorial.
Fitzgerald said the benefits go beyond helping infected individuals.
"From a larger societal perspective, the person with HIV is often the Mom or Dad. If you get them back to work or get them back functioning, you're helping everyone in that family."
The study was done in conjunction with GHESKIO (the Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections), an organization that works with the Haitian government and helps train, research, and provide care for HIV patients.
"It has often been said that our generation will be judged by our response to the HIV and AIDS pandemic," said Kim and Gilks. "Although there is much more to do, the GHESKIO project and responses from many other developing countries give us hope that the final judgment may be less harsh than we had feared."
Fitzgerald said the U.S. doctors simply jump-started the project. From there, the Haitian doctors, nurses, health care workers and counselors who were infected with HIV themselves provided care even in the midst of serious political unrest.
"The clinic never shut down. They were even dodging burning tires to get there," said Fitzgerald. "Our role was helping get the financial assistance, and provide training and technical support. Once they got that, they took off and they were amazing."
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