Anti-retro drugs fail to increase HIV patients’ lifespan

8 September 2007

THE widespread belief that the latest drugs for fighting Aids are reducing death rates has been confounded by a huge study covering 10 years of treatment which involved more than 22,000 patients in Europe and North America.

In a commentary on the study headed HAART's First Decade: Success Brings Further Challenges, Aids specialists say these 'somewhat paradoxical? trends may be due to changing characteristics in the patients. Between 1995 and 2003, while the proportion of HIV-infected male homosexuals nearly halved, there were more patients with tuberculosis, probably among immigrants and refugees from countries where the disease is more common. Scientists have noted previously that TB patients can become immediately more ill when treated with anti-Aids drugs, a phenomenon they have termed ?immune reconstitution disease?. The Lancet authors say this could have become more common due to use of more potent antiretroviral drugs.

They add that this would not fully explain the study findings, since ?the same trends in the rate of Aids were also present, although somewhat weaker, in men who have sex with men.? They also note that in all the risk groups, the time between starting on HAART and developing Aids decreased.

As well as being a blow to Aids doctors, the findings strengthen the hand of scientists who argue that by looking at supposed markers of HIV infection - and failing to demonstrate the presense of HIV itself - Aids science has gone seriously astray.

If patients with active TB, for example, test HIV-positive, they are held to be ?co-infected? and suffering from Aids. Yet as reported in The Business (9/10 and 16/17 May 2004 and 21/22 May 2006), HIV antibody tests have never been validated as specifying the presence of HIV. The same is true of so-called ?viral load? tests. There is also clear evidence that the bacterium which causes TB can itself cause people to test false positive for HIV. This raises the urgent question of whether TB should be included in the list of nearly 30 illnesses considered diagnostic of Aids, and sufferers treated with potent antiviral drugs for an infection they have not been proved to have. Since TB affects millions of malnourished people, removing it as an Aids-indicator disease would radically reduce estimates of HIV/Aids incidence in countries where many still live in poverty.

The findings also raise a wider question, of whether Aids drugs really do save lives. Despite clear short-term benefits in some patients, HAART has never been shown in a scientific trial to be better than no treatment at all. This was done by comparing the outcome in those receiving the active drugs with those given a placebo. This is despite a long-standing rule in medical science that ?no researcher can assess a drug's effectiveness with scientific certainty without testing it against a placebo,? as a leading Aids scientist has put it.

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Stephen Hart

January 4th, 2007 9:07pm Report this comment

What a marvel the internet is - imagine, if it were not for this, we would have nothing but the word of the local paper & our GP to go on - risky business when one begins to inform oneself!

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