Analysis of baseline CD4 count rather than the haemoglobin measurement is a better method for predicting short-term disease progression among HIV-infected patients in Asian countries, reveal a study by Therapeutics Research, Education, and AIDS Training in Asia (TREAT Asia) HIV Observational Database (TAHOD).
The collaborative study on the short-term disease progression among HIV-infected patients in Asia and the Pacific region is being conducted at 11 sites in the region. The Chennai-based YRG centre for AIDS Research and Education (YRG Care) is the nodal agency for conducting the studies in India. The study analysed 1260 patients with prospective follow-up data of 477 person-years of follow-up. The three-year study is to estimate the short-term risk of AIDS and death in patients undergoing antiretroviral therapy and to develop algorithms to predict the risk of AIDS and death in individual patients using prognostic markers with fewer resource requirements like haemoglobin level and body mass index.
The preliminary results of the study say that anaemia has been previously shown to be an independent predictor of HIV disease progression. Baseline haemoglobin measurement gets its significance only when baseline CD4 count is excluded from the prognostic model. However, the study mentions that haemoglobin may emerge as an independent factor in TAHOD during long-term follow-up of the disease.
Sources said each site recruited 200 patients both treated and untreated with antiretroviral drugs. The demographic details of patient, stage of disease and treatment history were collected and analyzed for primary data.
During a total of 477 person-years, 48 patients experienced clinical events after registering for the study. Of this, 18 died and 34 were diagnosed to have AIDS. Among the 34 patients who were newly diagnosed with AIDS, the most common illness symptom was tuberculosis followed by Oesophageal candidacies, toxoplasmosis, non-tuberculosis mycrobacterial disease etc. Study will re-analyse the outcome based on longer follow-up when high risked patients are optimally identified of disease progression.
The research scholars, Dr. J Zhou of National Centre in HIV Epidemiology and Clinical Research of the University of New South Wales in Australia and Dr.N.Kumarasamy of YRG Care says that the study on Asian patients have shown rates of disease progression similar to the combined rate of AIDS and death found in Western countries in 1996-1997. In this study, the rate of progression shown to AIDS or death is 10.1 per person-years.
The Western countries have documented the introduction of High Active Antiretroviral Therapy (HAART) in 1996 which led to a marked reduction of mortality and morbidity. Before the HAART era, the combined rate of AIDS and death in Western countries was recorded as over 40 per 100 person-years (in the period of 1994-1997). The rate decreased to around 10 per 100 person-years in1996-1997. Studies of TAHOD revealed patients who were not on antiretroviral treatment had a higher rate of disease progression than patients who were on treatment.
The TREAT ASIA project and TAHOD are funded by a grant from the American Foundation for AIDS Research (amfAR). Apart from this, YRG Care is conducting 39 major and minor research projects on AIDS control and vaccination.