Life expectancy rises with AIDS therapy in Uganda

Posted July 22, 2011 by Ugandan Diaspora News Team in Featured ~ 3,103 views


By Kerry Grens  ~  NEW YORK (Reuters Health) –  Ugandan HIV and AIDS patients receiving antiretroviral “cocktail” therapy can expect to live nearly as long as their compatriots who don’t have HIV, a new study finds.

“They can have almost a normal life expectancy, and live approximately two thirds as long as if they had not had HIV,” said Edward Mills, a professor of global health at the University of Ottawa in Canada and lead author of the study. “This is very good news.”

In the United States and other developed countries, combinations of antiretroviral therapies are known to increase the life spans of people with HIV to near-normal lengths, but how far these drugs can go in settings where patients don’t have excellent health care was unclear.

Mills and his colleagues looked at the health records of more than 20,000 people who received medications from The AIDS Support Organization in Uganda.

The total cost of an individual’s AIDS treatment in Uganda averages about $1,000 a year. Much of the funding for the drugs, which became available to these patients in 2004, has come from the United States.

About 1,500 of the patients died between 2000 and 2009.

From the data, the researchers predicted that patients in their 20s and 30s who are on the drugs would be expected to live an additional 27 years.

The normal life expectancy in Uganda is 55.

“One of the reasons this study is important is it looks at the most simple therapy available,” Mills said, referring to the lack of laboratory testing and treatments for other diseases that are available to HIV patients in the U.S. “Given that, we still demonstrate excellent outcomes.”

“We were heartened” by the results, said Dr. Deborah Cotton, deputy editor of the Annals of Internal Medicine, where the study was published.

“Even in a country like Uganda that has fewer options for drugs and people start later than is ideal, there’s a significant benefit of treatment,” said Cotton, who was not involved in the research.

The results do reveal some weaknesses in the HIV initiatives.

Children do not achieve life spans as long as adults do, and men do not fare as well as women.

Mills said children with HIV don’t live as long as adults because many of them were born with the disease and did not get early treatment.

A teenager starting therapy, for instance, can expect to live an additional 26 years, falling short of the average life span in the country.

As for men, there are no clinics or public health campaigns geared toward men, Mills told Reuters Health. “We need to figure out how to deal with men.”

At 35 years of age, a man with HIV on antiretroviral therapy can expect to live 22 additional years, compared to 32 extra years for a woman, for instance.

Though the drugs may work, only a minority of people eligible to receive them actually do.

In Uganda alone, the authors report, 80,000 people are waiting to start HIV therapy.

“The difficult and ironic part is we are seeing an advance at a time when economics are constrained,” Cotton told Reuters Health.

Mills said his findings can make an economic argument for investing in access to HIV drugs, because it means those most affected — the young adults in Africa, the workforce — will be healthier.

“I remember the days when someone would come to the clinic and we’d tell them to start preparing for their death,” Mills said. “Now what we’re able to tell people is you can live a very long life, and that means going back to work as well.”

SOURCE:  ~ Annals of Internal Medicine, online July 19, 2011.

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Ugandan Diaspora News Team

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