Development of AntiRetroviral Therapy in Africa (DART)
Development of AntiRetroviral Therapy in Africa (DART) was a six year clinical trial of anti-HIV therapy in 3300 patients with advanced HIV or AIDS in Uganda and Zimbabwe. The trial was the largest HIV clinical trial ever run in Africa and aimed to investigate two main questions: can anti-HIV drugs be given in the absence of routine laboratory tests, relying on clinical assessments instead; and can anti-HIV drugs be given intermittently rather than continuously to provide a similar level of benefit to patients but with less toxicity. The trial took 2 years and completed follow up in 2009. The results were reported at the 2010 International AIDS Society conference and published in The Lancet.
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DART found HIV therapy could be given safely without routine laboratory tests: regular laboratory tests offered little additional clinical benefit to populations when compared to careful clinical monitoring. The results suggest that many more people with HIV in Africa could be treated for the same amount of money as is currently spent if lab tests are not routinely used to monitor the effects of anti-HIV drugs (ART). The evidence from DART will be of value to low income or resource poor countries that are prioritising ART access over investment in expensive laboratory facilities.