Photo by Hugue-Robert Marsan for Fogarty/NIH
Haitian researchers have proven anti-retroviral
therapy programs are sustainable, even in resource-
poor countries. GHEKSIO clinics like this one report
excellent retention and adherence and a survival rate
of 75 percent at 5 years.
GHESKIO, the long-time Fogarty AIDS training and research grantee in Haiti, recently published data indicating the success of sustainable antiretroviral therapy (ART).
Researchers including Dr. Jean "Bill" Pape, the founding and current director of GHESKIO (the French acronym for the Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections), enrolled 910 HIV-infected patients in a clinical trial of different regimens and found that survival was tied strongly to adherence after the regimen was introduced.
Before the advent of ART in Haiti in 2003, 90 percent of AIDS patients died within a year and 100 percent within two years. After ART, such patients had a 90 percent survival rate after one year and 79 percent after five years.
The death rate was seven times higher in the first six months of treatment than after six months. Deaths after six months were associated with adherence of less than 90 percent, being over 50 years old and a tuberculosis diagnosis in the first six months of ART.
The study was sponsored in part by Fogarty.
Leger P, Charles M, Severe P, Riviere C, Pape JW, Fitzgerald DW. "5-year survival of patients with AIDS receiving antiretroviral therapy in Haiti." N Engl J Med. 2009 Aug 20;361(8):828-9