Important note: Information in this article was accurate in 2001. The state of the art may have changed since the publication date.
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United Press International - Wednesday, 7 February 2001
Ed Susman, UPI Science News
"There is a vast difference between being able to detect human immunodeficiency virus and gaining treatment compliance," said Dr. Carlos del Rio, associate professor of medicine at the Emory University School of Medicine, Atlanta. "Unfortunately the road between diagnosis and therapeutic success in this inner-city setting is truly a road less traveled."
"Significant advances in antiretroviral therapy are helping thousands of HIV patients keep the virus at bay," del Rio said, "allowing them to live nearly normal lives and avoid progressing to full blown AIDS."
But in his inner-city clinic, few patients took advantage of the treatment.
In a report to the 8th annual Retrovirus Conference in Chicago, del Rio said he and colleagues at Atlanta's Grady Memorial Hospital studied 135 patients who were newly diagnosed with HIV. He said that 24 of those patients died within a year of diagnosis, and of the other 103 patients only 12 people actually had their disease well controlled by available drugs.
"All the patients were offered social work assistance," del Rio said, but only 55 of the patients ever returned to the clinic for treatment. Of those, 22 dropped out of treatment within a year. Antiretroviral drugs were prescribed to 30 of the 55 who showed up at the clinic, and 20 of those patients were able to achieve an undetectable viral level for at least some point in their treatment.
But after a year, only 23 of the 103 patients remained on therapy, and 12 of them had undetectable viral levels.
Dr. Rob Janssen of the Centers for Disease Control and Prevention, Atlanta, said the bleak performance outlined by del Rio is not universal.
"Certain clinics in other inner cities have shown they can successfully treat higher percentages of patients," he said. However, Janssen said that those clinics often have extensive support services to help the patients in areas of substance abuse, mental health and other factors aside from HIV infection that impact treatment and compliance.
David Scondras, an AIDS activist with Boston-based Search for a Cure, said that del Rio's figures were not surprising considering the multiple factors of poverty, social estrangement and lack of education found in inner city clinics.
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