Our deputy director, Professor Kiat Ruxrungtham, was awarded the Excellent Researcher Award by the Thai Research Fund (Sor Kor Wor) for Thailand 2015 for his research work at the Faculty of Medicine, Chulalongkorn University
According to the Thai Red Cross Society Bulletin #204, issue April – June 2015, he was recognized for his accomplishments in translating basic science or laboratory/bench work to be used in the clinic. As per Professor Ruxrungtham, the most important things in research are:
- Real commitment
- Have an effective supportive research team
- Manage time well
- Always seek gaps of knowledge which can be used to address the country’s problem
Why do we need research?
Because even after 30 years of HIV, Thailand is still ranked as the fourth country in Asia with the highest rate of people infected with HIV. More than 1.2 million people are infected with HIV. More than 6 million people have died from HIV. Currently 4-5 million people are infected with HIV and 8,000-9,000 people are newly infected with HIV per year. Approximately 20,000 people die from AIDS (meaning that people die of AIDS every 2 hours).
Aside from this continuous problem/challenge, we have clearly seen that Thais and Asians cannot use the same treatment, care and dosage of antiretroviral drugs as those people from the Western countries because of genetic and body weight differences. In order to help the country to be able to provide more medications to other people per year and to ensure that Thais have fewer side effects without compromising the efficacy of the medications, therefore it is extremely important to have data on the appropriate dosages for Thais.
HIV-NAT, the Thai Red Cross AIDS Research Centre, and the Faculty of Medicine, Chulalongkorn University, have a strong network abroad and nationally so they can provide us with very high quality of research that can address specific problems of the country and the Asian region.
Examples of research we have conducted:
The PREDICT study investigated when we should start HIV treatment in children (age 1-12 years). The study was done in 300 children from 9 sites in Thailand and 2 sites in Cambodia. We found that the rate of illness or death from AIDS among those who start HIV treatment early instead of waiting until the CD4 dropped to less than 15% were comparable between both groups 3 years before follow-up. The main sponsor for this study was by NIH, USA. This study was also funded by the Thai Research Fund.
As for the PEARL study, we investigated the appropriate dosage of LPV in 200 Thai HIV-infected children. We found that for Thai children, the appropriate dose for LPV should be lower by 30%. On the other hand, the HIV-STAR study, was done in 195 HIV-infected Thai adults from 15 sites in Thailand who were drug resistant to the first-line HIV therapy. We found that 83% of the people on TDF+3TC+LPV/r had HIV RNA less than 50 copies/mL versus those only on LPV/r. Since 61% on only LPV/r were able to suppress HIV RNA to less than 50 copies/mL, therefore we do not recommend the use of LPV/r in HIV-infected people who are drug resistant to the first-line HIV therapy.
In another study, the LASA study, investigated the appropriate dose of ATV in 560 HIV-infected Thai adults. This medication is not only expensive but causes the whites of the eyes and the skin to become yellow if used at the standard dose of 300 mg in Thais (considered to be the side effects when used at a high dose). For HIV-infected Thai adults, we found that 200 mg ATV was sufficient, efficacious, safe (fewer side effects) and cost-effective by 50%. As a result of this study, Thailand will change its HIV treatment policy and guidelines based on the results of this study.
As demonstrated, these research results can be beneficial for the country or globally. The Ministry of Public Health Thailand, Division of AIDS, including NHSO and SSO, and professionals from the Thai AIDS Society have used these data to treat people nationally. Not only did the country save approximately 200 million baht per year or approximately 1,000 million baht in 5 years to treat 5,000 people, this has allowed the country to provide more people with appropriate, effective treatment and minimize the side effects. At the international level, WHO and other international organizations have also mentioned our results from the PREDICT study which has been published in world renown international journal Lancet Infectious Diseases that has an impact factor of 19.4. This information has been helpful in guiding physicians when to start HIV treatment in HIV-infected children.
Research is extremely useful in providing knowledge on diseases as well as ensure that the appropriate dosages of medications are used for certain groups of people. Standard doses based on data from Western countries are not always applicable to Asian who have a smaller frame. In addition, these types of data can help guide the country in providing better treatment, care and management of side effects, it can also save many millions of baht per year giving more HIV-infected people opportunities to access much needed medications through the universal health coverage program.