(CN) – Infection and death rates from HIV/AIDS over the last two years pale in comparison to when the epidemic first broke out nearly 20 years ago, but a new study published Tuesday says thousands of more lives can be saved in developing countries if patients are tested and treated sooner.
Study authors recommend commercially available testing kits in developing countries and starting treatment while waiting for test results, according to the study published in PLOS Medicine on Tuesday.
Nearly 30 years ago an HIV/AIDS diagnosis was considered a death sentence, but leaps and bounds have been made in treatment and testing.
At its peak, 150,000 new infections were reported in the United States in the mid-1980s, according to the U.S. Centers for Disease Control and Prevention. In 2016 that figure was closer to 40,000 and thanks to effective testing and treatment, death rates have plunged over the last 20 years.
But researchers at the University of Washington School of Medicine say there are too many patients in developing countries who seek treatment too late. They say a third of South African patients are reported to have advanced HIV when they finally begin treatment.
There are 7.2 million people living with HIV in South Africa, with 270,000 new infections reported and 110,000 AIDS-related deaths, according to the Joint United Nations Programme on HIV/AIDS.
As HIV breaks down the immune system these patients are at the highest risk for infections that can lead to death, but study authors say there are steps that can be taken to cut down on time to starting treatment.
Antiretroviral therapy – the management of HIV/AIDS with various medications to control the infection – should begin earlier if possible.
Mark Tenforde, infectious diseases specialist from the University of Washington, notes treatment for late-stage patients can be inadequate as it can hinge on the results of a white blood cell test which requires laboratory technology that might not be available.
The study posits three scenarios that can address the issue playing out in developing countries that lack easy access to laboratory testing.
“Our approach does not allow ‘the best to be the enemy of the good,’” Tenforde said. “Even the most resource-constrained settings can immediately implement interventions that have the potential to save thousands of lives, and further refinement can be offered in settings where rapid screening for common opportunistic infections is feasible.”
In one medical trial where patients were provided with treatment early on there was a 35 percent reduction in deaths or severe HIV-related illnesses. In the absence of same-day screening doctors should not wait to start treatment with medications.
It can take over 10 days to get results for a white blood cell test, versus a fingerstick test that can show results on the same day. Commercially available tests can detect white blood cell counts and other indicators that could give a good start for early treatment.
Third, rapid white blood cell testing and treatment can be done simultaneously if patients show signs of meningitis or other opportunistic infections.
Tenforde’s study finds cheap alternatives for white blood cell testing are readily available but developing countries will still encounter barriers as tests require specialized instruments.