STUDY: SECOND-LINE HIV DRUGS ARE EFFECTIVE BUT UNAFFORDABLE

New data presented by Médecins Sans Frontières (MSF) at last week's Conference on Retroviruses and Opportunistic Infections demonstrates good clinical outcomes for second-line antiretroviral (ARV) therapy in resource-poor settings.

MSF currently provides ARV therapy to more than 80,000 patients in 30 countries. In one project in South Africa, 20 percent of people needed to be switched to a second-line regimen after being on treatment for five years.

The organization presented a study of 352 adult patients who had been on first-line treatment for at least six months and then needed to switch to a second-line regimen either because of a drop in CD4 count or a clinical event. The second-line regimen included a new drug class, a protease inhibitor and at least one change in the nucleoside component. The overall probability of survival was 86 percent at 12 months, and the median CD4 gain was 131.

The study found that patients in resource-poor settings tended to stay on a first-line regimen much longer than patients in developed countries. The newer drugs needed for second-line regimens remain unaffordable and largely unavailable in African countries, according to MSF. Second-line regimens can cost between 10 and 50 times more than standard first-line therapy.