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New Approaches To HIV Treatment In Less-developed Countries (pp 404, 410)
August 01, 2001Two Viewpoint articles in this week's issue of THE LANCET highlight how the use of highly-active antiretroviral therapy (HAART) for HIV-1 treatment - currently only widely available in industrialised countries - could become accessible in less-developed settings. Both articles suggest new strategies for implementing HAART using infrastructure previously developed for tuberculosis control.
Last year, HIV surpassed other pathogens to become the world's leading infectious cause of adult death. More than 90% of deaths occur in poor countries, although new antiretroviral therapies have led to a drop in AIDS deaths in industrialised countries. The main objections to the use of these agents in less-developed countries have been their high cost and the lack of health infrastructure necessary to use them.
Paul Farmer and colleagues from Harvard Medical School, Boston, USA, have shown that it is possible to run an HIV-1 treatment programme in a poor community in rural Haiti, the poorest country in the western hemisphere. Relying on an already existing tuberculosis-control infrastructure, the authors provided directly-observed therapy with HAART to about 60 patients with advanced HIV-1 disease. Inclusion criteria and clinical follow-up were based on basic laboratory data available in most rural clinics; serious side-effects were rare and were readily managed by community-health workers and clinic staff. The authors conclude that directly-observed therapy of chronic infectious disease with multidrug regimens can be highly effective in resource-poor settings as long as there is sustained commitment to uninterrupted care that is free to the patient.
A second article by Anthony Harries and colleagues from the National Tuberculosis Control Programme and National AIDS Control Programme, Malawi, calls for a similar approach in sub-saharan Africa-integrating an HIV strategy within existing tuberculosis-treatment infrastructure. The authors stress the importance of a coordinated approach for use of HAART to prevent the emergence of multidrug resistance to HIV-1 treatment.
Anthony Harries comments: "An antiretroviral programme would introduce the most advanced level of care for people with HIV and AIDS who in most countries are not receiving even the minimum standard. However, antiretroviral drugs are already being provided in many countries in a chaotic fashion. We believe that a structured system of antiretroviral provision is urgently needed in sub-Saharan Africa. If this is combined with an essential package of care, the lot of patients living with AIDS could improve and drug resistance curtailed."
Lancet
A second article by Anthony Harries and colleagues from the National Tuberculosis Control Programme and National AIDS Control Programme, Malawi, calls for a similar approach in sub-saharan Africa-integrating an HIV strategy within existing tuberculosis-treatment infrastructure. The authors stress the importance of a coordinated approach for use of HAART to prevent the emergence of multidrug resistance to HIV-1 treatment.
Anthony Harries comments: "An antiretroviral programme would introduce the most advanced level of care for people with HIV and AIDS who in most countries are not receiving even the minimum standard. However, antiretroviral drugs are already being provided in many countries in a chaotic fashion. We believe that a structured system of antiretroviral provision is urgently needed in sub-Saharan Africa. If this is combined with an essential package of care, the lot of patients living with AIDS could improve and drug resistance curtailed."
Lancet
AIDS Current Events and AIDS News RSSMultiple health concerns surface as winter, vitamin D deficiences arrive
A string of recent discoveries about the multiple health benefits of vitamin D has renewed interest in this multi-purpose nutrient, increased awareness of the huge numbers of people who are deficient in it, spurred research and even led to an appreciation of it as "nature's antibiotic."
AIDS research reveals a lack of family-planning programs in Uganda
University of Alberta graduate student Jennifer Heys wants to make her message clear: there needs to be more education in Ugandan communities about contraception.
Many pregnant women avoid HIV screening in Africa
'Prevention is the best cure' is a common expression, but what happens if preventative measures are not used? A large proportion of pregnant Ugandan women are going out of their way not to be HIV tested, increasing the risk of mother-to-child transmission.
An atomic-level look at an HIV accomplice
Since the discovery in 2007 that a component of human semen called SEVI boosts infectivity of the virus that causes AIDS, researchers have been trying to learn more about SEVI and how it works, in hopes of thwarting its infection-promoting activity.
UAB Researchers Discover Antibody Receptor Identity, Propose Renaming Immune-System Gene
Researchers at the University of Alabama at Birmingham (UAB) have uncovered the genetic identity of a cellular receptor for the immune system's first-response antibody, a discovery that sheds new light on infection control and immune disorders.
UCLA study shows brain's ability to reorganize
Visually impaired people appear to be fearless, navigating busy sidewalks and crosswalks, safely finding their way using nothing more than a cane as a guide.
Research calls for better assessment of tests for tuberculosis, HIV/AIDS and malaria
A rapid and accurate diagnosis is the first step towards treatment in the fight against infectious disease.
Prioritizing low-cost, simple health measures would save 2.5 million child lives a year
Almost a third of the children under age five who die each year could be saved if governments rebalance health spending to ensure low-cost, simple interventions such as safe water and hygiene, bed nets and basic maternal and newborn care, leading aid agency World Vision said today. Currently, 8.8 million children a year die before age five, most of preventable causes.
No-entry zones for AIDS virus
The AIDS virus inserts its genetic material into the genome of the infected cell. Scientists of the German Cancer Research Center have now shown for the first time that the virus almost entirely spares particular sites in the human genetic material in this process. This finding may be useful for developing new, specific AIDS drugs.
Hoping for a fluorescent basket case
Although recent advances have raised hopes that a protective vaccine can be developed, acquired immunodeficiency syndrome (AIDS) remains a major public health problem.
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Total Resources International 250-Piece Outdoor First Aid Kit in Red EVA Case by Total Resources International This Deluxe 250 piece kit comes in a lightweight, durable, Cordura covered EVA moulded foam case for convenient storage and easy access. Contains the following items: 40 - Adhesive Bandages 3/8" x 1-1/2", 40 Adhesive Bandages 3/4" x 3", 10 - Butterfly Closure Bandages, 10 - Knuckle Bandages, 1 - Adhesive Tape 1/2" x 5 yds, 10 - Cotton Tip Applicators, 4 - Finger Splints, 6 - Sterile Gauze Pads 2" x 2", 6 - Sterile Gauze Pads 4" x 4", 1 - Sterile Trauma Pad 5" x 9", 2 - Gauze Rolls 2" x 4.1 yds, 4 - Examination Gloves, 1 - Instant Cold Compress 5" x 6", 1 - Metal Tweezers, 4 - Splinter Removers, 1 - Scissors, 2 - Burn Cream Packets, 2 - Lip Ointment Packets, 3 - Hydrocortisone Packets, 3 - Antibiotic Ointment Packets, 2 - Insect Repellent Packets, 2 - Sunscreen Lotion Packets, 24 - Alcohol... |
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