"ART programs are complex therapeutic regimens that require patients to take a minimum of three pills a day for the rest of their lives," said Dr. Karen Doucette, a professor in the U of A Division of Infectious Diseases. "It's often difficult for people in North America to maintain the regimens, so some critics believe these programs can't work in resource poor settings, where patients don't have the support--the pharmacists, the social workers, and the physicians, for example--that we have."
However, after reviewing more than 100 research papers on the topic, Doucette and her colleagues concluded ART programs have the same efficacy rates in both developed and non-developed countries. The general success rate in keeping the virus suppressed after being on the program for 12 to 18 months is about 60 per cent. The results are published this month in the journal Clinical Infectious Diseases.
Doucette said she was not surprised with the results, except for the fact that people in developing countries who received free ART drugs did so much better--30 per cent higher rates of success--than people who had to pay for their drugs.
"Although this intuitively makes sense, it was a satisfying surprise to be able to demonstrate the impact of payment for ART on its success. This has important potential implications for ART program development, which is ongoing in many resource-poor settings around the world," Doucette said.
According to the latest numbers from the UN, about 40 million people currently have HIV. The vast majority of these people live in developing countries, with almost 75 per cent living in Sub-Saharan Africa. The UN's goal is to provide at least 3 million people living with HIV/AIDS in low- and middle-income countries with ART by the end of 2005.
The number of people receiving ART has been increasing in every region in the world, with Sub-Saharan Africa doubling the number of people on ART to 500,000 in the past six months. As of June 2005, about 1 million people are on ART. Doucette believes these recent results are encouraging, but she says there must be ongoing political, financial and technical support to keep the trend going.
"Our study shows that there's no reason why people in Africa and other resource-poor settings won't follow ART regimens if they can access the treatments. We just have to make sure that everyone knows this and the support for these programs are strengthened over time," Doucette said.
For further comment, Dr. Karen Doucette may be reached at 780-407-1620 or karen.doucette@ualberta.ca.
Journal
Clinical Infectious Diseases