Of course--that's where the drugs are available.

****
AIDS Drugs Have Saved 3 Million Years Of Life In The United States:
HIV Disease Model Details Survival Benefits of HIV Therapies

National Institute of Allergy and Infectious Diseases, National
Institutes of Health - Friday, June 2, 2006

Media Contact: Anne A. Oplinger, (301) 402-1663,
aoplinger@niaid.nih.gov
http://www.aegis.org/news/niaid/2006/NI060602.html
--------------------------------------------------------------------------------

Increasingly effective HIV therapy--including a decade of highly
active antiretroviral therapy (HAART)--has provided 3 million years of
extended life to Americans with AIDS since 1989, report researchers
funded by the National Institute of Allergy and Infectious Diseases
(NIAID), part of the National Institutes of Health (NIH).

Rochelle Walensky, M.D., M.P.H., Kenneth Freedberg, M.D., M.Sc., and
their colleagues calculated that advances in HIV care have yielded a
total survival benefit of 2.8 million years in the United States. The
researchers also estimate that drugs to prevent mother-to-child
transmission of HIV have averted 2,900 infant infections, saving an
additional 137,000 years of life. The model projected that a person
initiating HIV therapy in 2003 could expect to live more than 13 years
longer than if he or she had been diagnosed in 1988.

The paper by Drs. Walensky and Freedberg, of Massachusetts General
Hospital and the Harvard Medical School Center for AIDS Research, and
their coauthors has been posted online by The Journal of Infectious
Diseases.

"Since the early 1980s, soon after the first reports of what we now
know as AIDS, NIH has devoted $30 billion to HIV/AIDS research," says
NIH Director Elias A. Zerhouni, M.D. "This study clearly shows the
dramatic impact that sustained investment in biomedical research can
have in improving the lives of Americans."

"As new HIV therapies have come into the clinic, we have witnessed the
transformation of HIV/AIDS from a rapidly fatal disease into a
controllable condition," notes NIAID Director Anthony S. Fauci, M.D.
"Although the rate of new infections in this country remains
unacceptably high, for many people, HIV infection is no longer the
death sentence it once was."

"Advances in HIV/AIDS treatments have been striking, particularly over
the past decade. Our goal in this study was to quantify the clinical
progress in AIDS care in terms of years of life saved," says Dr.
Walensky.

The researchers used a computer model, developed by Dr. Freedberg and
colleagues, that incorporates literature-based data of clinical
measures including HIV viral load, CD4+ T-cell counts (a measure of
immune system health), efficacy of HAART, and incidence of
opportunistic infections, to simulate HIV disease progression both
with and without treatment. Information about the number of people
diagnosed with AIDS and accessing health care each year between 1989
and 2003 came from U.S. Centers for Disease Control and Prevention
surveillance and other published data.

The investigators defined six eras of AIDS treatment between 1989 and
2003. In the first two periods, 1989 to 1992 and 1993 to 1995, drugs
became available to prevent two common infections--Pneumocyctis
jirovecii pneumonia and Mycobacterium avium complex. Although the
drugs provided an average per-person survival benefit during that time
of only 2.6 months, those early eras helped to shape the perception
that AIDS was a treatable condition, notes Dr. Freedberg. Drs.
Walensky and Freedberg subdivided the HAART era, which began in 1996,
into four periods corresponding to increasingly effective HAART and
other advances in HIV care.

For each year of the six eras, the investigators ran simulations of
HIV disease progression in two equal-sized groups of hypothetical
people with AIDS. One group received no therapy, while the other group
received all available therapies of that era. The model calculated a
per-person survival benefit and a total survival benefit in each era.
By 2003, the model projected that an individual beginning treatment
that year could expect to live more than 13 years longer than if he or
she had been diagnosed in 1988. The total survival benefit for the
24,780 people diagnosed with AIDS and entering care in 2003 was
330,189 years. The total cumulative survival benefit across all eras
from all forms of HIV therapy was 2.8 million years.

Dr. Walensky emphatically notes, however, that survival benefits
related to therapy are available only to those with known HIV
infection. But about one-fourth of people in the United States
infected with HIV are unaware of their infection, she adds. "We
calculated that a cohort of patients presenting with AIDS at higher
CD4 cell counts--simulating slightly earlier entry into care--had an
additional gain of 740,000 years of survival," says Dr. Walensky.
"These findings underscore the importance of expanded HIV testing and
better linkage to care for people who are HIV-infected, so that more
of them can realize the life-extending benefits of HIV therapies."

"This type of research can also be used to understand the tremendous
survival benefits that can be gained globally by continued rapid
expansion of access to these very effective HIV/AIDS treatments in
resource-limited settings," adds Dr. Freedberg. "This expansion is of
critical importance."

The National Institute on Drug Abuse and the National Institute of
Mental Health, parts of the NIH, also provided support for this
research.

NIAID is a component of the National Institutes of Health. NIAID
supports basic and applied research to prevent, diagnose and treat
infectious diseases such as HIV/AIDS and other sexually transmitted
infections, influenza, tuberculosis, malaria and illness from
potential agents of bioterrorism. NIAID also supports research on
basic immunology, transplantation and immune-related disorders,
including autoimmune diseases, asthma and allergies.

The National Institutes of Health (NIH)--The Nation's Medical Research
Agency--includes 27 Institutes and Centers and is a component of the
U.S. Department of Health and Human Services. It is the primary
federal agency for conducting and supporting basic, clinical and
translational medical research, and it investigates the causes,
treatments and cures for both common and rare diseases. For more
information about NIH and its programs, visithttp://www.nih.gov .

Reference: RP Walensky et al. The survival benefits of AIDS treatment
in the United States. J Infect Dis. 2006 Jul 1;194(1):11-9

060602
NI060602

--------------------------------------------------------------------------------

Published 2006 - National Institute of Allergy and Infectious Diseases
. All material contained in this report is in the public domain and
may be used and reprinted without special permission; citation to
source, however, is appreciated.

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational
corporation. AEGiS is made possible through unrestricted grants from
Boehringer Ingelheim, Bridgestone/Firestone Charitable Trust,
Bristol-Myers Squibb Company, Elton John AIDS Foundation, the National
Library of Medicine, Roche and Trimeris, and donations from users like
you. Always watch for outdated information. This article first
appeared in 2006. This material is designed to support, not replace,
the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and
neither endorses nor opposes any material. All information contained
on this website, including information relating to health conditions,
products, and treatments, is for informational purposes only. It is
often presented in summary or aggregate form. It is not meant to be a
substitute for the advice provided by your own physician or other
medical professionals. Always discuss treatment options with a doctor
who specializes in treating HIV.

Copyright ©1980, 2006. AEGiS. All materials appearing on AEGiS are
protected by copyright as a collective work or compilation under U.S.
copyright and other laws and are the property of AEGiS, or the party
credited as the provider of the content.