24 July 2017
A package of low-cost drugs designed to prevent deadly infections among people who are starting HIV treatment late could save 10,000 lives a year across sub-Saharan Africa, scientists believe.
About one in five people who start HIV treatment in poorer countries are doing so later than advisable, which means they have a low number of CD4 cells, a key component of the immune system. This leaves them far more vulnerable to developing serious illnesses.
Roughly one in 10 such people die within the first few weeks of treatment because their immune systems cannot recover fast enough.
HIV prevalence is particularly high in sub-Saharan Africa, with women and children especially vulnerable, but a study led by academics at University College London found that a preventative package of anti-infection drugs significantly reduces the number of deaths from HIV-related illnesses.
The researchers estimate that if the drugs were given to every patient in sub-Saharan Africa starting anti-HIV treatment and suffering from a low CD4 count, the drugs could prevent roughly 10,000 deaths each year.
The findings come as more than 6,000 scientists, researchers and global health experts converge on Paris for the IAS conference on HIV science.
Delegates at the four-day meeting, which started on Sunday, will discuss the latest developments in HIV research and how the science can be translated into policy.
The UCL study, published in the New England Journal of Medicine, involved 1,805 adults, teenagers and children from across east Africa.
Half of the participants were given a drug combination that included medicines used to combat TB (isoniazid), fungal infections (fluconazole), and worms (albendazole). The combination also included two antibiotics, azithromycin and co-trimoxazole,a drug routinely given to people starting HIV treatment in Africa.
Six months after starting this regimen, the mortality rate among patients fell. Almost 9% of patients taking the drug combination died, compared with 12% who didn’t take them.
The drugs bundle also reduced illnesses including TB, cryptococcal disease, a potentially fatal fungal infection, and candida disease, a fungal condition.
Diana Gibb, professor of epidemiology at UCL’s medical research council clinical trials, said the package of drugs will help the large number of people who do not realise they have HIV until the later stages, or who do not seek treatment due to stigma.