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MD's fact or opinion?
Oct 5, 2005

I recently got diagnosed with HIV and was told by my HIV specialist that I would eventually get AIDS. She said that in about 20 to 30 years and from the weakening drugs that I would probably be on for decades, I would eventually get AIDS. Is this true? Did I hear her correctly? Should she take a sensitivity course or it's just plain black and white, I will get AIDS later in my life? My Family doctor had referred me to her since she's the only HIV specialist part time (Fulltime ER doctor) in the San Luis Obispo area, according to him anyway. Any advise would be helpful to me. Thank you.

Response from Dr. Pierone

I must disagree with the statement that everyone with HIV infection will eventually get AIDS. It is true that the natural history of untreated HIV infection is development of AIDS in the majority of patients, but who ever said we should let nature take its course?

The reality is that HIV infection is a treatable condition and that one of the primary goals of therapy is prevention of immune decline and development of AIDS. AIDS is preventable with HAART, period. Can the medications fail? Yes, especially when adherence is sporadic. But even if viral breakthrough occurs there are salvage regimens and the resistant virus tends to be weaker so immune decline does not necessarily progress. So there is much cause for optimism (no nattering nabobs of negativism here!).

This does not even consider the impact that immune based therapy will have on altering the trajectory of the natural history of HIV infection. Researchers have recently made breakthroughs in therapeutic vaccination for HIV infection. These advances will eventually send the HAART-industrial-complex down the same path as the vinyl record industry.

Hope that this helps and best of luck to you!

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