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Cost of Treatment
Jun 27, 2001

Recently, I discovered that my 18 year old daughter tested positive for HIV. My daugher is mentally retarded, bi-polar, and a manic depressive. I was wondering if your could provide any insight as to the following: (1) her life expectancy with HIV (2) the likely cost of her treatment for the rest of her life (3)the most cost effective means of treatment available. I realize your time is limited so any help would be much appreciated. If you don't have time to answer all of the questions, any direction towards applicable literature, as regards my questions, would also be appreciated. Thank you

Response from Dr. Feinberg

This must have been very tough news for you and your family-- but don't despair. Current treatments are highly effective. While I cannot give you an accurate survival time because we have only had the most powerful combinations of medicine for about 6 years, many of the people treated recently have never been sick from their HIV, work full-time, have HIV- babies, and hopefully will live out something close to a normal lifespan. What is essential is to find a physician whose expertise is HIV and AIDS, so your daughter can get the best possible care.

The annual cost of combination treatment in the U.S. is in the range of $1200-1500. There is a federal program funded by the Ryan White Act that supplies medication for uninsured inviduals, although the details vary state by state. Physicians expert in HIV care will know how to connect you to a "case manager" who is a social worker knowledgeable about the resources available to your daughter. From what you've told me about her, i think the biggest challenge may be for her to take her medicine reliably, which is the key to successful treatment. You will need to find out what options exist for overseeing her medications.

What is most effective is a combimnation of 3 or 4 medicines that she can take without undue side effects. There are a number of such combinations. The doctor who prescribes the specific medicines will take potential side effects, your daughter's disease stage (as defined by her T helper lymphocyte count) and the amount of virus in her blood into consideration in choosing a combination that will work well for her.

The Centers for Disease Control maintains a list of HIV care sites in the U.S. (www.cdc.gov), and this information can also be obtained from other HIV-oriented web sites. You can also get information from your local city or county health department. Good luck to both of you!


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