An NIH study of treatments for high blood pressure, called the ALLHAT trial, shows some of the strengths and limitations of comparative effectiveness research to improve patient care. More...
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The HIV virus was first identified in the United States in 1981 and since that time has claimed the lives of more than half a million people. According to the Centers for Disease Control and Prevention (CDC), approximately one million people in the United States are living with HIV and AIDS today. Incidence of HIV peaked in the 1980s; however AIDS cases have declined dramatically, particularly due to the introduction of antiretroviral drugs in 1996. In fact, the U.S. AIDS death rate has fallen 70 percent due to further advancements in medicine and combination therapies.
Acquired Immune Deficiency Syndrome (AIDS) is a chronic, life-threatening condition caused by a virus called the Human Immunodeficiency Virus (HIV). Once contracted, HIV interferes with the body's ability to fight off other viruses and bacteria that the body could normally resist and that cause disease. As HIV disease progresses, it slowly wears down the body's immune system. AIDS refers to the later stages of an HIV infection. Many people can become HIV-positive but will not become sick for many more years.
Between 1987 and 2007, the pharmaceutical industry produced seven new classes of inhibitors developed to fight HIV. These new drugs have not only extended the lives of patients living with AIDS, they have also improved many patients' quality of life. For example, a patient diagnosed with AIDS in 1990 might expect to live for only 26 months, and patients were prone to severe infections contracted because of their body's inability to resist viruses and bacteria. A patient's only option for treatment at the time had to be taken every four hours "around the clock" and had very serious side effects.
Today, thanks to further advancement in new medications and therapy options that are significantly more sophisticated and convenient, patients can live symptom-free for years. Due to the development of protease inhibitors in 1995, the death rate from AIDS in the United States has fallen by 70 percent. Since the approval of the highly active antiretroviral treatment (HAART), the AIDS death rate per 100,000 has fallen from 16.2 in 1995 to 4.5 in 2004. HAART has also contributed to a significant reduction in the number of HIV-related hospitalizations. The number of HIV/AIDS hospital admissions fell by one-third between 1996 and 2000.
In 2006, the first once-a-day pill which combined three widely used antiretroviral drugs into a single tablet and dose was approved by the U.S. Food and Drug Administration (FDA). There are currently 75 new medicines in development in the United States for the treatment of HIV including an antisense gene therapy that enhances immune responsiveness against HIV, a topical microbicide that prevents HIV in women, an HIV maturation inhibitor that prevents the development of mature HIV viruses, and several HIV vaccines that are currently undergoing testing.
Continued innovation of new treatment therapies are especially crucial for HIV/AIDS because of HIV's ability to adapt and develop a resistance to existing medication. In August of 2007, a new class of HIV drugs called CCR5entry inhibitors was introduced by the biotechnology industry, and in January 2008, the industry gained approval for the first new drug in the non-nucleoside reverse transcriptase inhibitor (NNRTI) class called Intelence.