AIDS TREATMENTS STUDIED
By Emma Ross
AP 14 August 2000
London -- While new medicines have dramatically reduced the chances
of HIV patients developing AIDS, a new study indicates the percentage
who contract non-Hodgkins lymphoma has quadrupled since the drugs were
introduced six years ago.
People infected with HIV are defined as having AIDS when their immune
systems become so weak that they get one of 26 illnesses, including
non-Hodgkins lymphoma, as well as pneumonia, brain infections and some
Experts have known that the effectiveness of the new combination drug
therapy, called highly active antiretrovirals, varies depending on
which of the 26 AIDS-defining illnesses are involved. Some experts
have reported suspicions the new therapy doesn't work as well for
non-Hodgkins lymphoma as for the other diseases.
"This paper is probably the most compelling data to date to support
that suspicion,'' Dr. Mark Jacobson, a professor and AIDS specialist at
the University of California-San Francisco, said of the Danish study,
published this week in the British medical journal The Lancet.
In defining whether an HIV sufferer has developed AIDS, the U.S. Centers
for Disease Control also considers a drop in the blood levels of CD4 T
cells - the immune system's key infection fighters - to a level below
200 per cubic millimeter of blood.
The highly active antiretrovirals were introduced in 1994 to help
prevent HIV patients from progressing to AIDS. They inhibit the ability
of HIV to reproduce itself in the blood, keeping down the amount of the
virus in the body.
The cocktail has dramatically improved health and survival in the United
States and Europe.
The Danish study of 7,300 European HIV patients found that even if
patients' CD4 cell count dropped well below 200, the new combination
therapy still protected them from AIDS-defining illnesses.
Dr. Badara Samb, care adviser at UNAIDS, a joint program of the United
Nations and the World Health Organization, called that finding
Dr. Jens Lundgren, a professor at the University of Copenhagen who led
the study, said he found an overall drop in the progression from HIV to
AIDS of more than 90 percent, and the decline was sustained year after
Lundgren also found that the number of HIV-positive people developing
non-Hodgkins lymphoma, a cancer of the lymph glands, has declined among
people taking the new drugs, but not by as much as other diseases.
That means the cancer makes up a larger proportion of AIDS diagnoses
than it did before. In 1994, 4 percent of the progression from HIV to
AIDS was due to non-Hodgkins lymphoma. By the end of the study, the
disease accounted for 16 percent of AIDS diagnoses.
The study speculated that using the combination drug therapy earlier in
the progression of HIV might prevent the cancer.