When treating HIV/AIDS… the doctor is more important than the lab

[11 August 2008 - 10h08]
[mis à jour le 11 August 2008 à 17h09]

When deciding on the best HIV therapy, it seems that evaluating clinical symptoms such as fever and weight is just as effective as assessments based on the most advanced laboratory tests.

This finding by British researchers is excellent news for African and Asian clinicians who have to treat millions of patients without being able to count on costly and often inaccessible tests. The researchers produced mathematical projections for a 24-year period and according to their conclusions, the 5-year survival rate is almost identical for patients who undergo laboratory tests as for those who simply undergo clinical examination.

At 5 years, it appears that the survival rate is 83% with viral charge monitoring, and … also 82% with simple weight and fever checks. Over 24 years the corresponding values are 67% and 64% respectively.

Looking beyond this series of percentages, what is at issue is quite clearly ensuring widespread use of antiretroviral treatments in the world’s poorest countries. Without access to state-of-the-art laboratories to guide treatment with the latest generation of antiretrovirals some feared that patient care might suffer. But that doesn’t seem to be the case.

Source : The Lancet, 25 avril 2008

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