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AIDS drugs have saved 3 million years of life in the US

. Walensky.

The researchers used a computer model, developed by Dr. Freedberg and colleagues, that incorporates literature-based data of clinical measures including HIV viral load, CD4+ T-cell counts (a measure of immune system health), efficacy of HAART, and incidence of opportunistic infections, to simulate HIV disease progression both with and without treatment. Information about the number of people diagnosed with AIDS and accessing health care each year between 1989 and 2003 came from U.S. Centers for Disease Control and Prevention surveillance and other published data.

The investigators defined six eras of AIDS treatment between 1989 and 2003. In the first two periods, 1989 to 1992 and 1993 to 1995, drugs became available to prevent two common infections--Pneumocyctis jirovecii pneumonia and Mycobacterium avium complex. Although the drugs provided an average per-person survival benefit during that time of only 2.6 months, those early eras helped to shape the perception that AIDS was a treatable condition, notes Dr. Freedberg. Drs. Walensky and Freedberg subdivided the HAART era, which began in 1996, into four periods corresponding to increasingly effective HAART and other advances in HIV care.

For each year of the six eras, the investigators ran simulations of HIV disease progression in two equal-sized groups of hypothetical people with AIDS. One group received no therapy, while the other group received all available therapies of that era. The model calculated a per-person survival benefit and a total survival benefit in each era. By 2003, the model projected that an individual beginning treatment that year could expect to live more than 13 years longer than if he or she had been diagnosed in 1988. The total survival benefit for the 24,780 people diagnosed with AIDS and entering care in 2003 was 330,189 years. The total cumulative survival benefit across all eras from all forms of HIV therapy was 2.8 million years.

Dr. Walens
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Contact: Anne A. Oplinger
aoplinger@niaid.nih.gov
301-402-1663
NIH/National Institute of Allergy and Infectious Diseases
2-Jun-2006


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