Using drugs to prolong the lives of people infected with the AIDS virus could increase AIDS deaths overall by extending the time they can spread the deadly virus, a controversial study says.
The British researchers who conducted the study stressed their intention was not to suggest treatment should be withheld but to underscore the need to counsel those getting therapy to practice "safe sex" to help stem the spread of the virus."It is unethical to refuse treatment to individuals, given that AIDS is lethal," wrote Roy Anderson and his colleagues at the University of London in the prestigious scientific journal Nature.
"By emphasizing the possible effects of (treating AIDS patients), we hope to have drawn further attention to the need to improve counseling aimed at reducing high-risk beha-viors," the researchers wrote.
But the report raised concern that the analysis could contribute to discrimination against AIDS patients and undermine support for funding for treatment.
"If there is any implication that people (AIDS patients) are irresponsible then the chance for further discrimination becomes very real," said Dr. Mervyn Silverman, president of the American Foundation for AIDS Research in New York.
"My experience and the experience of most of my colleagues is people are very responsible," Silver-man said. "I think to assume that just by virtue of keeping people alive you will propagate the virus and therefore it would be better not to keep people alive would be very cynical."
Dr. Sten Vermund of the National Institute of Allergy and Infectious Diseases said the study was based on the assumption that AIDS drugs do not reduce infectiousness.
"The bottom line is the entire model is based on a spurious assumption. And that is an assumption that treatment has no impact on infectiousness. I think that's improbable," he said.
"Where I object is the fairly extreme statement - I'm reading between the lines here - of saying treatment of the individual is exacerbating the problem for the community," said Vermund, an AIDS epidemiologist.
"There are plenty of people who would like to cut AIDS treatment dollars and here's a justification to do that with quasi-scientific data," he said.