0
Sign In  | Subscribe
18 August 2009, Vol 151, No. 4>
Summaries for Patients | 18 August 2009

Five-Year Outcomes of the China National Free Antiretroviral Treatment Program FREE

[+] Article and Author Information

The summary below is from the full report titled “Five-Year Outcomes of the China National Free Antiretroviral Treatment Program.” It is in the 18 August 2009 issue of Annals of Internal Medicine (volume 151, pages 241-251). The authors are F. Zhang, Z. Dou, Y. Ma, Y. Zhao, Z. Liu, M. Bulterys, and R.Y. Chen.


Ann Intern Med. 2009;151(4):I-42. doi:10.7326/0003-4819-151-4-200908180-00003
Text Size: A A A

What is the problem and what is known about it so far?

HIV is the cause of AIDS. AIDS is a potentially deadly illness that interferes with the body's ability to fight infection and certain types of cancer. Treatments that contain several drugs (called highly active antiretroviral therapy [HAART]) have greatly improved outcomes for HIV-infected patients. This therapy is expensive and can be difficult to provide to the patients who need it, particularly in developing countries. In 2002, China began a program to provide free HAART to patients who met the national criteria for treatment. Most studies of the outcomes of programs that provide HAART in developing countries have been of short duration (1 year), and whether the benefits seen early in the programs continue over time is less clear.

Why did the researchers do this particular study?

To see how patients were doing in China's National Free Antiretroviral Treatment Program after 5 years.

Who was studied?

48,785 patients who were enrolled in the program.

How was the study done?

The researchers collected information on patient deaths and CD4 cell counts over 5 years. Doctors use blood tests called CD4 cell counts to monitor patients with HIV infection. The CD4 cell count decreases as the disease gets worse, so low CD4 cell counts are bad. One measure of HAART failure is that CD4 cell counts drop even though the patient is receiving treatment. This can happen because the virus becomes resistant to certain drugs over time. Resistance means that the drug is no longer effective against the virus.

What did the researchers find?

After about 6 months of treatment, death rates decreased to levels similar to those seen in HIV-infected patients who receive HAART in other developing countries. The death rates stayed at this low level through year 5. Unfortunately, about one half of patients had CD4 cell counts that suggested treatment failure after 5 years.

What were the limitations of the study?

The study was only 5 years long, and CD4 cell count is not the best way to measure treatment failure.

What are the implications of the study?

China's National Free Antiretroviral Therapy Program reduced death rates among HIV-infected patients to levels similar to those of other developing countries. However, treatment failure was common in the program and may be due to the limited number of drug choices. This means that once resistance developed, patients had few options for other drugs they could take.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general jounals
BMJ 2010;341:c5893-c1494.

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy This Article

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Register Now for a free account
Advertisement

Related Content

Customize your page view by dragging & repositioning the boxes below.

Journal Club
Topic Collections
PubMed Articles
Transient liver injury associated with the early recovery of HCV-specific T-cell responses and HCV rebound in HIV-1/HCV coinfected patients undergoing highly active antiretroviral therapy.
Journal of acquired immune deficiency syndromes (1999) Issue date: 2013 Feb 1
Steady-state pharmacokinetics of zidovudine in Chinese HIV-infected patients.
Chinese medical journal Issue date: 2012 Jun

Annals of Internal Medicine

Other Resources

Copyright © 2013 The American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704

Buy This Article

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Register Now for a free account
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)