Progress in treatment of HIV with a limited budget

ANRS (French National Agency for AIDS Research) lead research to find the efficiency of dual therapy for HIV-positive patients with several mutations. Three sub-Saharan countries were studied: Senegal, Burkina-Faso, and Cameroon. Lamivudine and protease inhibitor were meant under the dual-therapy as a second-line treatment.

WHO highly recommend second-line treatment for countries with limited resources. There are two possible ways of second-line treatment — monotherapy and combination of two drugs. Monotherapy shows satisfactory results, but it is quite dangerous to use it in resource-limited countries, where the patients have no access to regular virological monitoring. The second way is a combination of lamivudine and protease inhibitor — it is efficient and affordable for a country with a limited budget.

ANRS 12286 MOBIDIP studied 265 patients (divided into two groups) with the viral load of 200 copies/mL in Senegal, Burkina-Faso, and Cameroon for 96 weeks. The first group received boosted protease inhibitor (BPI) as a monotherapy for 48 weeks; then the monotherapy was interrupted and changed on triple drug therapy. Patients of the first group received a triple drug therapy until the end of the research. The second group received a combination of BPI and lamivudine all the 96 weeks of the study.

The increase of CD4 cells-level was higher in the group of monotherapy. Both of treatment ways were well-tolerated by the patients. ANRS 12 286 MOBIDIP research shows that dual therapy can be successfully used in budget-limited countries.

All the results of ANRS 12286 MOBIDIP research were published yesterday in the Lancet journal.