HIV patients who remain under doctor's treatment live longer

A new study has found that HIV patients who drop out of care do not live as long as those who remain under a doctor's treatment.

The study was conducted by a team of researchers led by Dr. Thomas Giordano at Baylor College of Medicine and Veterans Affairs.

As part of the study, researchers looked at 2,619 men with HIV for more than four years. Most were diagnosed between 1997-1998 at a VA hospital or clinic and began treatment after Jan. 1, 1997.

Researchers divided the men into four groups based on the number of quarters they visited their HIV physicians or health care provider in the first year after starting treatment.
Sixty-four percent of them had at least one visit in all four quarters, 18 percent in three of four quarters, 11 percent in two of four quarters and 6 percent in only one quarter. The researchers then looked at how long the patients survived after that first year.

Researchers found that 16 percent of the patients died. Those who had poorer retention in care or visited the physicians less during the year after starting treatment had a greater risk of dying than those who saw the physicians at least once each quarter.

The study also found that patients with visits in one quarter had nearly twice the risk of dying compared to patients with visits in all four quarters.

"In an era when highly active therapy directed against HIV (the human immunodeficiency virus that causes AIDS) is keeping people alive, understanding the value of regular medical care is crucial," Giordano said.

"We know that adherence to medications is critically important. Patients who have trouble taking their medicines regularly will do less well. But what about those people who aren't even seeing a doctor regularly. Before this study, we had only a vague understanding of the magnitude of the problem, and we certainly didn't know whether it affected survival," Giordano added.

"The next step is to figure out how to get them to stay in care," he added.

The findings of the study were published in the June issue of Clinical Infectious Diseases and are available on line