China reportedly slashes AIDS mortality

China has slashed AIDS mortality by nearly two-thirds since it began distributing free antiretroviral drugs in 2002, Chinese government scientists are reporting, according to a New York Times story.

About 63 percent of all those needing AIDS drugs are getting them, up from virtually zero in 2002.  That has caused a 64 percent drop in mortality in “person-years,” as China measures it, an estimate of how long someone would have lived without the disease.

AIDS mortality dropped to 14.2 per 100 person-years in 2009, from 39.3 in 2002.

 The study, led by China’s national center for control and prevention of AIDS and other sexually-transmitted diseases, was published online on Wednesday by Lancet Infectious Diseases.

China’s success in such a short time “is a testimony to the young midlevel scientists who convinced the leadership that this was the right thing to do,” said Dr. Myron Cohen, an AIDS specialist from the University of North Carolina who has lived in China and helped it battle the epidemic.

A different report, released Wednesday by the International Labor Organization of the United Nations, criticized China’s health-care system, saying that people infected with H.I.V., the virus that causes AIDS, were frequently turned away by hospitals. 

The report, based on interviews with patients, health care workers and hospital managers, said patients are sent by general hospitals to infectious-disease hospitals. But they often refuse to perform surgery, for example, for fear that paying patients will avoid the hospital if word spreads that it operates on AIDS patients. China’s national center for AIDS control, a co-author of the report, agreed that hospital discrimination was a problem.

The number of infected people in China — 740,000, according to estimates by the government and U.N. AIDS — is large by comparison with most countries, but small in a population of 1.3 billion. Of those, 323,252 have been tested and 82,540 are being treated.

If the total caseload estimate is correct, China has tested nearly half its infected people. By comparison, the United States estimates that 80 percent of its 1.1 million infected people have been tested.

China now begins treating when a patient’s CD4 cell count, a measure of immune system strength, drops below 350 per cubic millimeter.

It is now debating whether to start treatment as soon as a patient tests positive for H.I.V., Dr. Cohen said. A study released last week showed that this strategy, known as “treatment as prevention,” could reduce the risk of new infections by 96 percent by protecting an infected person’s sexual partners.

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