The study Risk of death from AIDS And survival benefit without affecting viral suppression
- For people with advanced HIV infection, Increased antimicrobial prophylaxis significantly reduces the risk of imminent AIDS death from any opportunistic infection in the months immediately following initiation of antiretroviral therapy.
- It should be noted that improved antimicrobial prophylaxis consisted of continuous trimethoprim-sulfamethoxazole plus at least 12 weeks of isoniazid-pyridoxine, 12 weeks of fluconazole, 5 days of azithromycin, and a single dose of albendazole emphatically mitigate the risk of death than In the control group where he hears not only maoios risk and a higher percentage of mostes.
For people with advanced HIV infection, increased antimicrobial prophylaxis significantly reduces the risk of death from any cause within months of initiating antiretroviral therapy, the researchers said.
While anti-HIV treatment is becoming much more widely available in developing countries, many people still need more intensive care because they have a severely damaged immune system (AIDS) and around 10% die of opportunistic infections In the weeks after starting HIV treatment, according to A. Sarah Walker, PhD, Da University College London and colleagues.
That is why all people who are involved in the fight against HIV and AIDS insist on saying,
AND, AFTER TESTED, PROTECT YOURSELF WITH T-SHIRTS!
Their lives are worth more than a
But in a randomized study, those receiving a treatment with the use of better antimicrobials had a lower risk of death than 27% than those who received standard prophylaxis with trimethoprim-sulfamethoxazole, according to which Walker and his colleagues reported In the 20 edition of July New England Journal of Medicine.
The benefit was sustained for at least 48 weeks and came without affecting viral load suppression or increased toxicity, the researchers found, and it was found to reduce the risk of death from AIDS and manifestations of opportunistic infection (s).
Reinforced prophylaxis may be especially important in places where laboratory tests such as cryptococcal antigen tests, tuberculosis diagnosis and bacterial culture are not available, commented Nathan Ford, PhD and Meg Doherty, MD, PhD, both from the Department of HIV / AIDS In Geneva.
"This approach is practical to reduce the occurrence of diseases and consequently Saving many lives for common causes, Which may occur rapidly, "Ford and Doherty argued in An editorial In the issue of the issue of reducing the risk of death from AIDS.
But they warned that there are "some concerns about this approach that merit careful evaluation," including the risk of creating resistance to some of the drugs involved and the cost-effectiveness of using general prophylaxis where appropriate diagnostic tests are available.
The so-called REALITY study - for Reducing early mortality in HIV-infected adults and children who started antiretroviral therapy had enrolled 1,500 people in Uganda, Zimbabwe, Malawi and Kenya.
All had advanced HIV infection, evidenced by a count of CD4-positive T cells that was less Than 100 per mm 3 (The median age was 37), although almost half were without symptoms or were only moderately symptomatic. 
Factorially and openly, the researchers investigated three interventions - improved antimicrobial prophylaxis, adding the drug raltegravir to anti-HIV therapy and providing supplementary feeds - but so far only report the effects of the prophylaxis package.
The primary outcome of the analysis was all-cause mortality, 24 weeks after initiation of ART, but researchers followed patients up to 48 weeks.
Approximately eight hundred and ninety-five patients received standard prophylaxis of trimethoprim-sulfamethoxazole, while another nine hundred and six obtained the improved package with continuous trimethoprim-sulfamethoxazole plus at least 12 weeks of isoniazid-pyridoxine (Co formulated with trimethoprim-sulfamethoxazole Combined in a single fixed dose tablet) 12 weeks of fluconazole, 5 days of azithromycin and a single dose of albendazole.
At 24 weeks, Walker and colleagues reported that a hundred and Eight patients under standard prophylaxis had died, Compared to 80 receiving the enhanced package, Obtaining a risk rate of 0,73 favoring the latter (P = 0,03).
And the effect was sustained: at 48 weeks, 127 and 98 patients in standard and enhanced prophylaxis, respectively, died, for a risk ratio of 0,76, which remained significant.
In addition, they reported, increased prophylaxis significantly reduced the incidence of new cases of:
- Tuberculosis (7,1% versus 10,2%) - Editor's note: what I saw about it ... risk of death from AIDS associated with Tuberculosis is devastating
- Cryptococcal infections (1,0% versus 2,6%)
- Candidiasis (1,1% vs. 2,6%)
- Hospital Admissions (17,0% vs. 20,7%)
Cryptococcal and unknown cause deaths were significantly lower among those who obtained the improved package, but there was no significant difference between groups in the rate of severe bacterial infection, Walker and colleagues reported.
The rates of serious adverse events and adverse events of 4 grade were lower but not significantly in the advanced prophylaxis group, while rates of HIV viral suppression and adherence to antiretroviral therapy (ART) were similar in the two groups , As reported.
Enhanced prophylaxis is "relatively inexpensive, has a low tablet weight and an acceptable side effect profile, and would be easy to implement" in low-income settings, they concluded, because it relies only on the clinical screening CD4 test for Asymptomatic patients with advanced HIV infection (AIDS).
The report comes as researchers and clinicians are gearing up to meet next week in Paris for the 9 meeting of the International AIDS Society on HIV.
In summary, the study demonstrated survival benefit without affecting the trajectory of viral suppression caused by ART.
The study was supported by the UK Medical Research Council, the UK Department for International Development, the Wellcome Trust and the PENTA Foundation.
Hakim has disclosed relationships with Mylan Pharmaceuticals, Gilead Sciences and Johnson & Johnson. Walker has revealed relationships with Tibotec and Gilead Sciences.
Ford and Doherty made no disclosures.
By Michael Smith, Correspondent, MedPage Today in 19 July 2017
 Translator's Note:
When I saw antimicrobial I was bemused, and after translating and starting the first review, I went to wikipedia, searched for the term and found little about it, but a part of what is there, I transposed to this post.
antimicrobial (All links in this article open in other tabs)
From Wikipedia, the free encyclopedia Jump to: navigation, search The links below also open in other tabs.
Um Antimicrobial (Brazilian portuguese) ou Antimicrobial (European Portuguese) Is a substance that kills (microbicide) or inhibits the development (microbiostatic) of MicroorganismsAs bacteria, fungi, virus ou protozoa.
 I understand this condition as AIDS, since immunodeficiency is established with a typical risk of Real death
 This is usually due to the late discovery of positive serology, when it is much more qualified as Immunodeficiency, which, unfortunately, can lead to death.
 Just a dull remark: when talking about Walker and his colleagues, who really because the hand in the crowd are colleagues
 I remember, and I can never forget. In those years, before the arrival of the so-called "cocktail party", I went through a long period when there was not a day when I did not "lose someone to death" and, in the meantime, the most iconic case of my experiences Are those of someone with whom I have established a strong bond of friendship. Good square, friendly, strong as a bull I even thought that if I had to fight him, I would have to climb him first. Well, he arrived at CRT-A with a severe diarrhea, which unfortunately was caused by cryptococcus and I do not remember if there was no effective treatment for it or if the race against time could not be won ... The truth is that He lost liters and gallons of water in every crisis of diarrhea and the human body, remember his science classes, is composed in 64% by water and he, whose name I will not write, died in just over twelve or Fourteen hours, by dehydration, a pale reflection of what he had been, utterly ruined by this unfortunate and disastrous disaster. I'm glad to hear that this can be avoided these days.
 No comments. In the name of human lives, no financial movement that reduces the availability of prophylaxis could exist
 In summary, AIDS
 "I do not know how you can do that!" Eur-lex.europa.eu eur-lex.europa.eu