Other researchers fear that concentrating on meeting the
WHO target will mean less money for disease prevention, and schemes to
help the millions orphaned by Aids.
Professor Alan Whiteside, director of the Health, Economics and HIV/Aids
Research Division at the University of Natal in South Africa, argued that
other important programmes might be at risk.
He said: "Antiretrovirals are a way forward. You can use these drugs.
But there are things you can use before that. Prevention must remain our
first goal - you must stop other people being infected."
He added: "Unless the international community is prepared to make
a lifetime commitment, we must be very careful about going down that road."
page 2 of 8
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Controlling liver enzymes saves lives
Just mild elevations in two liver enzymes - to levels
that are commonly ignored by most physicians - are related to an increased
risk of death in people with HIV, according to new research by the University
of Pittsburgh.
Raised levels of the enzymes alanine transaminase (ALT) and aspartate
aminotransferase (AST) in the blood indicate injury to liver cells, and
sometimes other cells in the body. They are mildly elevated in one-third
of patients with HIV, and increases are largely overlooked by physicians
"unless they are two to four times above the normal range,"
said Amy Justice, Professor of Health Services Research at the university.
"Our study shows that even the patients whose elevations are mild
to moderate have a death rate that is nearly twice that of patients with
normal levels."
Raised liver enzymes can indicate antiretroviral or other drug toxicity,
viral hepatitis or alcohol abuse.
"Chronic viral hepatitis is known to substantially increase the risk
of liver cancer," Justice said. "Additional research must be
done to determine whether HAART exacerbates this risk."
"Furthermore, the fact that the most common cause of death among
people with HIV is liver failure
suggests that liver injury may be a major limiting factor in the effectiveness of current HIV treatment," she added.
