Paris: The use of a home-based anti-retroviral treatment could significantly reduce mortality among adults with HIV in poor nations, especially in Africa, according to a study.

Anti-retroviral treatment (ART) is the most effective clinical intervention for reducing the death rate of people with HIV, but those in developing nations - where 90 per cent of those infected live - have limited access to the life-prolonging drugs.

The standard, triple-drug treatment is only available to about 10 per cent of those in need in sub-Saharan Africa, say international health officials. Barriers to treatment include a lack of funds, the high cost of the medication, a shortage of trained health care providers, and long distances between clinics and patients.

To be effective, ART programmes require that patients take medication regularly, and be monitored for toxic reactions and opportunistic infections.

Jonathan Mermin of the Centres for Disease Control and Prevention in Nairobi and his colleagues monitored a group of HIV patients and their families in rural Uganda through a phased series of treatments over a five-year period.

They began in 2001 by providing basic counselling, diarrhoea prevention and hygiene education to 466 HIV-infected adults and 1481 households without any infected members over a five-month period. In a second phase, a daily dose of antibiotics was administered to HIV patients to fight bacteria that take advantage of compromised immune systems.