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Lower toxicity in future HIV drugs may improve life expectancy
Researchers from the University of Pittsburgh suggest that lowering the toxicity of new drugs for HIV would positively affect younger patients with HIV, according to a report in PLOS ONE.
“The side effects of treatment remain one of the primary reasons that HIV drug regimens are discontinued,” Mark Roberts, MD, MPP, professor and chair of the department of health policy and management at the University of Pittsburgh Graduate School of Public Health, said in a press release. “By decreasing the toxicity and side effects of HIV drugs, you increase the amount of time that patients can stay on that life-saving treatment regimen. Some side effects, such as increased cardiovascular risk, also cause problems that directly contribute to premature mortality.”
Roberts and colleagues used an existing simulation model of the optimal time to initiate antiretroviral therapy and enhanced the model to also consider the rate of availability of new ART drugs. They evaluated whether new drugs affected the predicted optimal time to initiate ART, and also analyzed whether the future new drugs would affect life expectancy and quality-adjusted life expectancy (QALE).
They found that in young patients with high viral loads, the availability of new drugs could result in a 4.9% increase in life expectancy and an 8% increase in QALE. However, the life expectancy gains from new drugs was less than 1% for most other patients. The researchers also conducted a sensitivity analysis and found that if the rate of newly available drugs increased, the results would not be significantly different.
However, they also found that if future ART drugs has lower toxicity, the benefit would be seen for many patient groups, increasing the QALE by as much as 10%.
“This availability of new drugs means that as the drugs a patient is on become less effective, doctors can adjust the therapy to use a new, more effective drug,” Roberts said. “And if that new drug has a low toxicity and is well-tolerated by the patient, then they are more likely to take it regularly so that it is as effective as possible.”
Disclosure: The researchers report no relevant financial disclosures.