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Experts: HIV Prescription Drug Monitoring as Good as Blood Test

Researchers say it is possible to tell how well anti-HIV drugs are working by monitoring how compliant patients are about taking their medication. Investigators say the monitoring works at least as well as more expensive AIDS tests in resource poor countries. VOA's Jessica Berman reports.

Experts say there are two ways to measure the progression of AIDS. In rich countries, doctors commonly use an expensive blood test that measures the amount of virus in the blood to see how well anti-viral drugs are working to suppress the AIDS virus.

In developing countries, people who are HIV-infected are most often monitored with a less expensive, occasionally unreliable blood test that measures their CD4 cell count.

CD4 cells are immune system cells that drop when the AIDS virus has progressed. Experts say a change in a patient's HIV therapy is required.

So, researchers wanted a quick method of detecting treatment failure in resource poor countries.

By conducting a simple analysis of the pharmacy records of 1,900 HIV-positive patients in nine African countries in the first year of treatment, an international team of experts found they could predict which patients would do better on therapy than others. Investigators found they were patients who were the most diligent about filling their prescriptions.

Gregory Bisson of the University of Pennsylvania says the blood free method worked extremely well.

"Looking at adherence over the past say six months was more accurate predictor than was looking at CD4 counts," he said.

Bisson says the prescription monitoring method, which is blood free and relatively inexpensive, offers a proactive alternative to CD4 testing as a way to detect how well HIV positive individuals are doing on anti-viral therapy.

"If you find they have less than 100 percent adherence, you could intervene, and you could try to identify what barriers they are having try to improve that in order to decrease the risk of subsequent virologic failure," he added.

The study on HIV drug prescription monitoring is published this week in the open access journal PLoS Medicine.