ART should be given early, says Surya Rao
The impact is seen primarily on morbidity and mortality events in the first six months, he says
VISAKHAPATNAM: Noted physician Kutikuppala Surya Rao says that the life expectancy of people living with HIV goes up significantly due to combination of anti-retroviral therapy (ART).
Quoting success stories from various parts of the world, he said it is a matter of reassurance that combination ART continues to increase in life expectancy for patients in high-income countries. Those who are rich and who can afford combination therapy and who start as early as possible have significant life expectancy according to recent studies.
Dr. Rao, a recipient of Padma Sri, says that he conducted a study at his hospital in Kancharapalem and kept 340 positive patients for three years from November 2006 to December 2009 under observation. All the patients were given combination therapy and started as soon as they were confirmed HIV positive. As many as 314 (92 per cent) have been doing well.
“The ART Cohort Collaboration (ART-CC) is a multinational cohort study of antiretroviral-naive HIV-positive patients initiating combination antiretroviral therapy,” which obviously makes a big difference. Of course patients who initiate HAART may stop, there are discordances in CD4 count increases, some keep viral load undetectable and some don’t, lifestyle matters including exercise, diet, smoking etc,” he states quoting reports from based on studies.
Dr. Rao says as per studies done worldwide, life expectancy is lower in patients with lower baseline CD4 cell counts than in those with higher baseline counts.
He is of the opinion that ART should be given early. Waiting to complete opportunistic infections treatment before initiating ART appears to be associated with a higher risk of AIDS-related disease progression and /or death without any significant benefit in terms of safety or virological response.
Studies show that there is a significant difference favouring the early treatment group in the secondary outcome of AIDS progression/death. The impact is seen primarily on morbidity and mortality events in the first six months.