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ARV drugs could effectively eradicate AIDS, say experts

Source: Standard Digital

Updated Sunday, January 20 2013 at 00:00 GMT+3

By Bernard Muthaka

In a shift in perception, experts are now looking at the power of Anti-Retroviral (ARV) drugs in preventing new HIV infections, rather than a way of helping those already infected live longer.

They suggest and those who test HIV-positive should immediately be put on ARV drugs. The more optimistic ones project that this shift could help the world halt the spread of HIV in five years, and even eradicate HIV/Aids altogether in 40 years.

While immediate treatment with anti-retroviral drugs would reduce the viral loads in people infected, experts in developing countries feel consideration needs to be given where drug monitoring is not widespread.

Kenya is one of the countries where monitoring of ARV drug adherence and monitoring of CD4 counts is a challenge, with experts worried that many Kenyans with HIV are not finding out when to start treatment, or whether the treatment is working for those already on ARVs. Such information is derived from both CD4 counts as well as viral load measurements.

“Without monitoring, it is therefore, difficult to determine harmful side effects and whether to change the ARV regimen a patient is using,” says Dr Ahmed Kalebi of Pathologists Lancet Kenya.

Dr Kalebi says there is a disturbing trend of doctors requesting ARV resistance studies when it is too late.  According to him, the lack of viral load monitoring is associated with resistance in the majority of those who experience viral failure within the first year of use of ARVs.

To try and reduce the effects of shortage of viral-load testing in poor countries, the World Health Organisation developed clinical and immunologic criteria that can be used to define treatment failure. However, Dr Kalebi says that incidences of mis-classification of ARV failure by such clinical criteria can be as high as 45 per cent.

CD4 cells are the primary targets of the HIV virus. The CD4 count is the number of CD4 cells per microlitre of blood and it is the standard laboratory test for monitoring progression to Aids and risk of opportunistic illnesses. It is generally recommended that for monitoring purposes, the CD4 count should be repeated approximately every 3-4 months both in stable

untreated patients and in patients on ARV treatment.

Viral load testing on the other hand quantifies the HIV viral burden in the plasma. In some situations, the viral load may help to determine whether to initiate or change ART.

With millions of lives dependent on expanding access to anti-retroviral treatment to all those clinically in need, researchers and clinicians are partnering in new ways to find the most effective and efficient methods to deliver treatment and strengthen health systems. In Kenya, one such initiative is a franchising approach involving private doctors and hospitals to increase access to planned care and lifesaving treatment for HIV/Aids.  The approach, a brainchild of Gold Star Network, is designed to substantially cut the health care bills for those who can pay for services and facilitating referrals to the public care system for those who cannot pay in the private sector.

The Network has developed a Commodities Management System for the procurement and supply of HIV drugs and test kits at access rates to providers directly through Pharm Access Africa Limited, a logistics management organization.

This lessens the risk of patients stopping treatment due to shortage of drugs or unaffordable cost.

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One Response to "ARV drugs could effectively eradicate AIDS, say experts"

  1. Natalie says:

    Obama lifts HIV travel ban ab Worldofjames wamjdoflores.com/2009/11/02/obama-lifts-hiv-travel-ban view page cached Well done Barack Obama for taking a step another step that once again softens the image of the USA: the lifting of entry restrictions to people who are HIV positive. From the page

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