Physician Experience Is a Major Contributor to Survival

Canadian AIDS experts say that physician expertise in treating HIV infection has an independent effect on the survival of HIV-positive patients, particularly among patients who have progressed to an AIDS diagnosis. According to a study by the British Columbia Centre for Excellence in HIV/AIDS that researchers published in the March 28 issue of the journal AIDS, 'Inappropriate care of advanced patients and patient nonadherence may be the strongest determinants of patient survival, rather than the time at which therapy is initiated prior to CD4 counts of 200.' The study of 1,400 people showed that when anti-HIV drugs were started when CD4-cell counts were above 200, doctor experience did not matter. But when drug therapy was initiated when patients had CD4-cell counts under 50, the risk of death was more than double for patients treated by inexperienced doctors. According to the study, doctors with six or more HIV patients were deemed to be experienced.