Potent drug cocktails cut the death rate a whopping 75% among AIDS patients in a large health trial. The finding, reported in tomorrow's New England Journal of Medicine, underscores the dramatic success of protease inhibitors and other new drugs. But researchers warn that the long-term benefits--and possible side effects--of the drugs are unclear.
After the 1995 debut of protease inhibitors, which prevent HIV from replicating, immune cell counts in patients on the drugs generally began to stabilize and deaths started to decline. To better quantify the trend, researchers from the Centers for Disease Control and Prevention in Atlanta and several other institutions tracked the treatment and health of 1255 AIDS outpatients from 1994 to 1997.
The patients' death rate--measured as the number of deaths per 100 person-years of observation--plummeted nearly 75% almost immediately after they began taking protease inhibitors and other antiretroviral drugs in the second half of 1995, the researchers say. They noted a similar decline in the incidence of the three most common AIDS-related infections: cytomegalovirus, tuberculosis, and pneumonia.
These encouraging results should not "give the impression that the search for better therapies is over," says Robert Gallo of the Institute of Human Virology in Baltimore. Antiretroviral therapies do not eliminate HIV from the body, and the drugs are extremely expensive, costing at least $12,000 per year.