disease in check
\nWashington, July 23 (ANI): HIV-infected young adults, blacks, injection drug users and those who lack health insurance are less likely to have the disease under control while taking antiretroviral drugs, according to results of a study by AIDS experts at Johns Hopkins and the University of Pennsylvania.
\n The study also pointed out that tens of thousands of Americans taking potent antiretroviral therapies, or ART, to keep their HIV disease in check may not have as much control over the viral infection as previous estimates have suggested.
\n In what is believed to be the largest and longest review of viral load test results in people with HIV disease ever performed in the United States, researchers found that the number of people sustaining viral suppression \u2013 consistently, at 400 or less viral copies per millilitre of blood, year after year \u2013 is roughly 10 percent less than previous estimates.
\nAccording to senior study investigator and infectious disease specialist Kelly Gebo, M.D., M.P.H., the team\u2019s latest findings underscore just how difficult it is to successfully treat HIV disease and prevent its spread even when people are taking effective ART.
\nGebo said, \u201cIf we are not fully suppressing the virus as much as we thought, then we are not fully preventing and reducing the likelihood of HIV transmission, either.\u201d
\nSome 426,000 of the estimated 1.2 million Americans infected with the virus that causes AIDS are taking ART and are under the routine care of a physician.
\nGebo said that, overall, while ART has improved significantly within the last decade, with once-a-day pill regimens replacing more complicated, multidrug schedules, \u201cour study findings suggest that physicians and other health care providers still need to do more to promote drug adherence among our patients, and make sure people take their antiretroviral therapies as prescribed.\u201d
\nWithout that extra effort, she stated, \u201cMore people are potentially at risk of becoming infected with HIV, and those already on ART are at risk of developing drug resistance, too.\u201d
\n Gebo is an associate professor at the Johns Hopkins University School of Medicine and the University\u2019s Bloomberg School of Public Health.
\n As part of the decade-long study, more than 100,000 individual blood test results were reviewed, all obtained with permission from the medical records of 32,483 infected adults. Seventy percent were men. Everyone prescribed ART had their blood viral levels carefully monitored at more than a dozen established HIV clinics, including the Moore Clinic at The Johns Hopkins Hospital.
\n Among the study\u2019s specific findings was that the percentage of participants who tightly controlled their HIV disease was 72 percent in 2010, the last year for which viral load counts were analysed. This represented a major increase from 45 percent in 2001, but was significantly less than the 77 percent to 87 percent figures widely cited in 2011 reports from the U.S. Centers for Disease Control and Prevention, and in studies by other leading Hopkins and Canadian researchers.
\nAccording to study lead investigator Baligh Yehia, M.D., M.S.H.P., M.P.P., a postdoctoral fellow at the University of Pennsylvania School of Medicine in Philadelphia who trained as a medical resident at Johns Hopkins, all previous reports were based on single-year or one-time-only recordings of blood viral levels, rather than a review of every patient\u2019s individual test results from year to year. The latter, he noted \u201cmore accurate\u201d depiction of people\u2019s response to ART over the long term.<\/p>\n
Other key findings in the latest report were that younger people, ages 18 to 29; blacks; injection drug
\nusers; and those without private health insurance were almost twice as likely as older people; whites;
\nmen who have sex with men; and those with private insurance to not have fully suppressed blood viral
\nlevels.<\/p>\n
\u201cOur data shows that while tremendous strides have been made in sustaining viral suppression,
\nphysicians and other HIV care providers need to be more vigilant in monitoring the viral loads in young
\npeople, African-Americans, injection drug users and those who lack health insurance,\u201d said Yehia.<\/p>\n
Gebo and Yehia next plan to use their study data to develop programs for helping people with HIV
\nadhere to therapy and keep routine appointments with their physicians. The team also has plans to
\ninterview infected people who consistently adhered to ART and medical care, and those who did not, to
\nbetter understand the reasons behind successful and failed attempts to sustain and tightly control the
\ndisease.<\/p>\n
The team\u2019s findings are set to appear in the Journal of the American Medical Association online. <\/p>\n\n