Johns Hopkins Medicine
Media Relations and Public Affairs
Media contact: David March
August 12, 2006
NEWS TIP FROM JOHNS HOPKINS MEDICINE
XVI INTERNATIONAL CONFERENCE ON AIDS, AUG. 13-18, TORONTO, CANADA
EMERGENCY ANTI-HIV DRUG PLAN “AMAZING SUCCESS” IN UGANDA
Early results from a large study of HIV-infected people in rural Uganda show that seven out of 10 who got free, emergency access to antiretroviral drugs successfully suppressed the AIDS virus in their blood to nearly undetectable levels. The findings are being presented by researchers at Johns Hopkins and the Rakai Health Sciences Program who are leading the study.
Access to the drugs, provided at a reduced cost of less than $400 per year to Ugandan aid organizations, comes from the President’s Emergency Plan for AIDS Relief (PEPFAR), inaugurated in January 2003. PEPFAR currently provides free access to drug therapy for approximately 400,000 people in sub-Saharan Africa infected with HIV, treatments that can cost upwards of $12,000 per year in the United States.
The two-year study of the free-access program involved 510 newly diagnosed men and women, average age 36, in the largely rural Rakai District of Uganda. All were in the advanced stages of AIDS and most in need of therapy. Study participants came from the Rakai cohort, a population of 12,000 people in Uganda who are being monitored to determine how HIV spreads in the country.
Subjects received standard triple-drug combination therapy and were monitored through semiannual check-ups and blood tests. Drug combinations used included treatment with either stavudine (d4T) or zidovudine (AZT) plus lamivudine (3TC), plus nevirapine (Viramune) or efavirenz (Sustiva). Treatment was provided in mobile clinics, such as medical officers on motorcycles riding from town to town.
Some 264 completed therapy as prescribed for a six-month period between check-ups. By January 2006, 216 (81 percent) had satisfactory increases in the number of key CD4 immune cells needed to fight infection, above 50 cells per cubic milliliter of blood. Some 166 (63 percent) had fully suppressed levels of the virus in their blood, at less than 400 viral copies per cubic milliliter of blood.
Steven J. Reynolds, M.D., M.P.H., lead researcher, says the results “are an amazing success story and demonstrate how a global relief program can dramatically suppress the virus, even among the rural, hard-to-reach populations in Africa.” Reynolds adds that having two-thirds of an infected population with undetectable viral loads is a treatment-progress story from Africa comparable to any program in North America or Europe.
Early immunologic and virologic responses to ART in rural Rakai, Uganda. Steven J. Reynolds, J. Kagaayi, Godfrey Nakigozi, F. Makumbi, P. Opendi, P. Nakamya, Ronald Gray, Thomas C. Quinn, Maria Wawer, T. Lutalo, and David Serwadda
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(Scheduled for presentation at 12:30 p.m. ET, Thursday, Aug. 17; poster presentation #THPE0181, Poster Exhibition Area, Level 800, South Building of Metro Toronto Convention Center.)