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alternatives to HAART
Apr 8, 2008

Hi Doctor. I was diagnosed positive last week, and believe I contracted it about 4 years ago. At this early stage, I have not yet even seen a doctor to have my viral load checked. I've been reading constantly since the diagnosis trying to learn all I can, and my question deals with the choice of begnning HAART or not. Beginning such a regimen terrifies me because of the ensuing dependancy and side effects. I'm well read on your opinion of AIDS Denialists, herbal treatments, 'quackeries' and other, to which I agree with your opinion. What would you say to me if I was contemplating just living a healthy life here on out, eating right, exercise, vitamins, and come what may? Are there any studies to indicate the body can keep HIV in check perpetually without anti-retroviral meds? I know the general consensus is to eventually go on HAART, but surely other methods have been analyzed by established doctors.

Response from Dr. Frascino

Hi,

Sorry to hear about your recent diagnosis. I totally understand how overwhelming this period of adjustment to your new reality as an HIVer can be. I applaud your efforts to learn as much as possible about HIV and various treatment options. Yes, my views on AIDS denialists, herbal remedies and other various "quackeries" are no secret, especially to some renowned and truly whacky "quacks" who send me some amazingly nasty notes. However, science is science. Facts are facts and they should never be equated with myths, fiction and anecdotes to prey on those in desperate situations. As far as your question as to whether just living a "healthy life" might be enough to keep HIV in check, we don't need to do that experiment, because it's already been done with disastrous results! Early in the epidemic we had no HIV medications. We tired diet, exercise, stress reduction and many other non-medical interventions. HIV-infected folks continued to die right on schedule as the virus consumed their CD4 cells, leaving them susceptible to an amazing array of opportunistic infections and malignancies, which eventually caused their deaths. Truly effective anti-HIV medications didn't become available until mid-1996! From that point on there has been a remarkable decrease in both HIV morbidity and mortality. Certainly without those drugs I would not be here responding to your question. (I was infected in January 1991.) Yes, antiretrovirals can have side effects and toxicities; however, there is no doubt the risk-benefit ratio of treatment versus no treatment is no longer in question. The effects of these medications have been, in a word, "miraculous." For a perspective on the HIV pandemic I suggest you Netflix the PBS documentary "The Age of AIDS." It chronicles the first 25 years of the epidemic. Continue to read and learn. The choices you will eventually have to make will become clearer and your fears will lessen. Be sure to choose a competent and compassionate HIV specialist with whom to work. He or she should be an excellent source of information as you begin your journey cohabitating with HIV. Being "virally enhanced" is not the end of the world. In many ways it's a new beginning.

I'm here if you need me, OK? With the current advances in HIV care and treatment there is an excellent chance both you and I will die of old age rather than AIDS. See you at the old-folks home! OK?

Dr. Bob


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