Wider distribution of drugs needed to cut AIDS deaths in China

China needs to identify and provide effective AIDS drugs to more HIV patients infected through sexual contact and use of dirty needles if it wants cut HIV death rates and avoid broader transmission of the virus, researchers said on Thursday.

In a paper published in medical journal The Lancet, the researchers found that mortality rates were much higher for such cases of infection, as China has long targeted patients infected through botched blood-selling schemes in the 1990s.

“Increased attention must be given to these populations to diagnose HIV infection earlier and increase treatment coverage,” wrote the researchers, led by Fujie Zhang at the National Center for AIDS/STD Control and Prevention in Beijing.

Zhang said death rates among HIV patients treated with AIDS drugs, or antiretroviral therapy (ART), fell sharply from 2003 to 2009. But patients infected by sexual contact or unhygienic needles remained at a disadvantage.

“Treatment coverage for blood donor HIV patients is up to 80 percent and their mortality is 6.7 percent. But for injecting drug users, treatment there is only 43 percent and mortality is much higher at 16 percent,” he said by telephone.

The study showed that patients given highly active antiretroviral therapy (HAART) - or stronger cocktails of three AIDS drugs - saw the most drastic reductions in death rates.

“Death from HIV is strongly linked to ART. Before ART, the mortality rate was 40 percent. After ART, it was 14.2 percent. Those on HAART had mortality of 5.7 percent,” said Zhang.

China estimates that 740,000 people are infected with HIV, the virus that causes AIDS, though the number actually diagnosed stands much lower at 323,252 by end-2009.

Of these, 82,540 were treated free under a state program started in 2003 that targeted mainly impoverished rural folk who became infected through selling their blood in the 1990s.

Experts recommend that HAART be given early not only to boost survival but also to control replication of the virus in patients and reduce wider transmission of the virus.

“HAART reduces mortality and increases quality of life and if HAART is implemented on a large scale, it reduces transmission in the population,” Zhang said.

“Treating one person perfectly is meaningless, but treating many will bring transmission down. So we must increase coverage and then treat early.”



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