Early anti-AIDS treatment cuts death rate in half

Prescribing powerful antiviral drugs to patients with HIV, the virus that causes AIDS, even as they're being treated for pneumonia or cancer, cuts their death rate, a study found.

In the past, doctors focused first on controlling the AIDS-related illness and delayed prescribing antiviral drugs lest the combination cause side effects or be hard for patients to manage, said Andrew Zolopa, director of the AIDS clinical trial unit at Stanford University School of Medicine.

In the U.S., 60,000 to 70,000 new cases of AIDS are diagnosed each year, and half of the patients have advanced disease, Zolopa said. His findings, published in the journal PlOS One, may resolve a long- running issue in AIDS treatment by showing that patients have a better chance of surviving if they're given antiviral drugs from the start.

Zolopa, lead author of the new study, said he started the research because he was unable to answer a question from doctors at Stanford Hospital. They wondered if they should treat HIV-infected patients with antiviral drugs if they were already being treated for infections like pneumonia or meningitis. These drugs have become the mainstays of AIDS treatment.

"My response was always the same: I don't know," said Zolopa. "I'd come by, see the patient and say we'll treat the infection first, get him out of acute crisis and let him go home. Then we'd do an assessment and make sure he was ready to start and comply with antiretroviral drugs."

"That answer was wrong," Zolopa said.

By the time patients would come back for a follow-up appointment and get started on the new medications, as many as three months could go by, Zolopa said.

Word of his study is getting out quickly.

When Michael Saag learned last week that a burn patient in an Alabama intensive care unit was infected with the AIDS virus, he knew what to do because he'd heard early results of this research.

Trauma doctors at the University of Alabama at Birmingham Hospital were treating the man with drugs to combat bacterial pneumonia. Saag, director of the Center for AIDS Research at the University of Alabama at Birmingham, found the man also had HIV and began giving him the antiviral drugs that have become the mainstay of AIDS treatment.

"These data are very compelling and in our neck of the woods, we've changed our practice," Saag said. "I think it will save some lives."