HAART Response Similar in HIV-Infected European And African Patients

Originally published by Reuters Health, June 3, 2002

NEW YORK (Reuters Health) — Patients infected with the subtypes of HIV-1 common in Africa respond initially to highly active antiretroviral therapy (HAART) as well as patients infected with the subtype that predominates in the West, according to a report in the May 24th issue of AIDS.

Although more than two-thirds of those infected with HIV-1 worldwide live in sub-Saharan Africa, the authors explain, the likely efficacy of HAART in these patients harboring non-clade B virus (the subtype most common in Europe) remains unproved.

Dr. Jonathan N. Weber, from Imperial College School of Medicine in London, and colleagues used their database to compare the response to HAART of 97 African HIV-infected patients with that of 265 HIV-infected patients classified as European.

There was no significant difference between the two groups in the initial virological response to HAART, as measured by the time to viral load undetectability, the authors report.

Moreover, there were no significant differences in the changes in CD4 cell counts, the report indicates, although the African cohort had lower baseline levels.

"No significant difference was attributable to non-B HIV-1 subtype (predominantly A, C, and D) in the initial virological response," the researchers write. "In addition, not only were the results comparable between the viral subtypes, but they indicated that HAART is likely to be equally efficacious in Africa as in the industrialized world."

However, while the European group maintained its initial viral load reduction until at least 21 months on average, the African patients experienced an increase in viral load after a mean of 9 months.

"Further studies to measure drug levels and assess adherence are necessary to explain the poorer long-term viral load data," the researchers suggest, "as it is possible that the explanation for this is not virological."

This question aside, Dr. Weber and colleagues find the results "extremely encouraging" and conclude, "On the basis of these findings, there is no justification for withholding HAART from Africa on virological grounds."