Triple therapy used against subtype B HIV-1 effective against subtype C

Triple therapy, widely used in the United States and Europe to fight against one subtype of HIV-1 appear to be particularly effective in South African patients infected with other viral subtype and comorbidities such as tuberculosis or Kaposi's sarcoma, according to a study published in the "Journal of Infectious Diseases
Subtype C HIV-1 is common in South Africa and in developing countries where it spreads rapidly populations. It is also in these countries as tuberculosis and Kaposi's sarcoma are the main causes of morbidity and mortality due to AIDS.

In developed countries, where subtype B predominates, the advent of HAART has dramatically reduced morbidity and mortality associated with HIV. Edana Cassol in association with researchers in Durban (South Africa) and the United States, wanted to know if these drugs could be equally effective on subtype C.

In the study posted on the website of the medical journal, 49 patients infected with HIV-1 were followed by researchers. Nearly half (21) also suffered from tuberculosis and 28 others were suffering from Kaposi's sarcoma.

TB patients first received a standard anti-TB treatment and antiretroviral combination was proven in patients infected with the B strain of HIV-1. Patients with Kaposi's sarcoma have meanwhile been directly under the antiretroviral therapy, which has been added for some cancer chemotherapy.

Responses to HAART, as measured by plasma viral RNA levels and CD4 counts in peripheral blood, have been very positive.

After three months, 94% of TB patients and 80% of those with Kaposi's sarcoma had an undetectable blood viral RNA, a result still higher than that observed in the populations of developed countries affected by the sub- B, say the authors. The decline occurred from the 7th day of treatment and continued steadily until the virus is undetectable.

In both patient groups, the researchers observed a rapid increase in CD4 cell count and a slight decrease, followed by a second increase, reflecting also on what had been seen in the U.S. and European patients.

The authors conclude that the treatment of infections caused by subtype C HIV-1 therapeutic use against infections caused by subtype B is beneficial virological and immunological plans even in cases of opportunistic infection and low CD4.

In an editorial published in the same journal, Timothy P. Flanigan (Rhode Island) and Chennai (India) welcomed the results and the fact that they put an end to two ideas about the treatment of HIV infection in developing countries: one that results in developed countries are not reproducible in poor countries, and secondly that patients in developing countries are too affected by opportunistic diseases to benefit from therapeutic advances.

It will, however, that the results obtained by the team Edana Cassol be confirmed in the longer term before declaring victory, they said.