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will individuals today affected with hiv all share this fate?
Aug 19, 2002

Hi Doctor Wohl, I just recently read the article by Gregg Gonsalves posted here under what's new at the body. Gonsalves states in the passage,

"With Fred Gormley's death; the death of my friend, Frank Moore; and Indian AIDS activist, Ashok Pillai, I know four people who have died of AIDS in the past month. Fred, Frank and Linda ran out of therapeutic options and had to face the virus without effective medicine. Ashok died of toxoplasmosis, which is a preventable opportunistic infection.

Someone tell me again that HIV/AIDS is a chronic yet manageable disease."

This brief part of the passage expresses grave concern for all individuals affected with the virus. As a doctor, do you believe that recently infected individuals now in the year 2002 will all share similar fates as these individuals or will new drugs be introduced that will allow us to prevent this from happening? Thank you again!

Warmest,

Jennifer

Response from Dr. Wohl

Jennifer,

Sometimes I feel we do forget we are dealing with a deadly virus for which there is no known cure. We are still living in the heady days of potent HIV therapies, where one cocktail is easily swaped for another and people complain more about body fat and lipids than about KS lesions and wasting syndrome. How long will this last?

Of course, I don't know. It is clear HIV therapies continue to make a major impact in the lives of many people and certainly on the epidemic as a whole in areas where these drugs are available. But I too see where potent therapies fail people. Where I work the majority of people dying with HIV just never were able to get their act together and take care of themselves and comply with therpy. Their sub-optimal adherence leads to the cultivation of resistant virus and a subsequent buring of antiretroviral bridges. They get sick. Some die. However, this is not always the case and sometimes these drugs just don't work as well as we need them to. Right now a very dear man named Adam who I have gotten to know over several years as his physician is struggling to live in an intensive care unit, even though he played by the rules and took all his meds and was clean and sober. Is this the fate of all persons living with HIV/AIDS?

I do not think so. Bad things happen but not to everyone. The next few years WILL bring better therapies and the years after than even more advances. We are paving the road as we travel it. We just need to keep 'doing the right thing' (live healthy, make informed choices about our treatments, avoid poisons that wreak our immune systems, etc) so we can get there. Is there really any alternative? - DW



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