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Nurses "should lead HIV therapy"

Nurses could play a greater role in the delivery of HIV treatment, according to a study of South African nurses published in The Lancet.

A trial investigating whether there was a divide between the level of care and the clinical outcomes among HIV patients who had undergone antiretroviral therapy (ART) found that HIV management by nurses was "safe and effective" and could lead to an overhaul of ART delivery.

The study looked at 812 HIV patients in South Africa between 2005 and 2007. The patients were randomly assigned to either nurse-managed ART care or doctor-managed ART care in equal numbers.

The researchers found that overall, 192 patients in the nurse group experienced treatment failure compared to 179 in the doctor group, while the number of deaths - 10 in the nurse group and 11 in the doctor-managed group - were also relatively similar.

Instances of viral failure and toxicity failure were also closely matched.

The findings add further weight to the argument that nurses could be used to plug the gap in the number of key health workers that are able to deliver HIV care and could lead to a worldwide adoption of "task-shifting", where nurses take over the bulk of HIV treatment.

The authors said the findings "suggest that HIV management by nurses can be safe and effective, probably even for those starting therapy with advanced HIV infection."

Copyright © Press Association 2010

The Lancet