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Tuesday, 11 July, 2000, 16:47 GMT 17:47 UK
Women 'may miss out on HIV drugs'
HIV test
New guidelines may be needed on HIV treatment
Current HIV treatment guidelines may result in more men than women being eligible for treatment.

A study by researchers at Johns Hopkins University in Baltimore shows that women carry lower levels of HIV in their blood than men, especially during early phases of the infection.

However, they have the same risk as men of developing Aids.



Current guidelines should be reassessed, particularly early in the course of infection

Dr Timothy Sterling, Johns Hopkins University

In some cases doctors offer anti-retroviral treatment only to those people who are thought to have significant levels of the HIV virus in their system.

The researchers suspect that this policy could result in more men getting offered treatment than women - particularly in the early course of infection.

Dr Timothy Sterling, assistant professor of infectious diseases at Johns Hopkins, said: "You would assume that if women start out with a lower viral load than men, they would have a lower risk of progressing to Aids, but they have the same risk."

Viral loads

Currently, doctors generally offer anti-retroviral treatment to patients when tests indicate greater than 20,000 copies of HIV per milliliter of blood.

The Hopkins team found that while both men and women had the same risk of developing Aids, women had lower viral loads than men during the first few years of becoming HIV positive.

While men who progressed to Aids had average viral loads of roughly 78,000 copies per ml in the first year, women who progressed to AIDS only had 17,000 copies per ml.

Women continued to have lower HIV levels than men in subsequent years, but by the fourth year, the differences tended to dissipate.

Over the past several years, various studies have yielded conflicting results as to whether viral loads differ between HIV-positive men and women.

Using data from the Aids Linked to Intravenous Experience (ALIVE) study of 3,380 intravenous drug users, Dr Sterling and his colleagues studied individuals who had contracted HIV within 12 months of a previous visit and before December 1997.

Out of the total ALIVE group, 202 qualified for their study, 156 men and 46 women.

Dr Sterling said: "The current viral load cutoffs for the initiation of anti-retroviral therapy were developed based on data from men.

"This study demonstrates that current cutoffs would result in sex-biased differences in treatment eligibility, and that therefore current guidelines should be reassessed, particularly early in the course of infection."

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See also:

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01 Jun 00 | Health
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