The Extraordinary Hope of Antiretroviral Therapy in South Africa (Even for Patients with Tuberculosis or Kaposi Sarcoma!)

HIV and AIDS treatment in North America and Europe was revolutionized by the use of triple combination ART which resulted in dramatic decreases in morbidity and mortality. As the potency adverse effects and ease of ART administration continue to improve HIV is becoming more and more manageable within the developed world. The hallmark of triple combination ART has been profound suppression of viral load to undetectable levels (<400 copies/mL) with increases in CD4+ cell counts. Moreover ART has uniformly translated to improved health for HIV-infected persons by decreasing the risk of AIDS-related complications and death as well as by decreasing the overall cost of medical care. Unfortunately the benefits of ART have been slow to arrive in the developing world particularly in sub-Saharan Africa which bears a disproportionate burden of the HIV/AIDS epidemic. As ART has percolated slowly into the developing world 2 myths have been propagated. The first myth is that the benefits of ART observed in developed areas of the world cannot be replicated in resource-poor settings. This myth gave rise to many arguments that have been made to discourage the introduction of this extraordinary life-saving therapy in the areas of the world that need it the most. (excerpt)