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Quality vs. Quantity of Life
Aug 25, 2002

Hello, I am a 26 year old male. I was diagnosed with HIV in March 2002 (I was infected in Dec 2001). My lab info: 3/02 VL 7595/CD4 547; 5/02 VL 12257/CD4 745.

I have not started treatment yet. I know it is inevitable that I will have to start treatment someday. I have been reading as much as I can about the treatments available and accounts of patients on treatment. I keep reading that HIV drugs can help you live longer. I also read accounts of patients and their side effects and of patients that take a STI/drug holiday "feeling alive again".

For me I would rather live not as long and have more years of feeling "normal" and battle a year or two with OI in the end, instead of 20 years of dealing with side effects, disability, loss of job, and toxic medication just so I can have an undetectable VL and live longer. It doesn't seem worth it. It seems that with treatment, I should be saving for disability instead of retirement.

To be quite honest, I am absolutely terrified of HIV meds. (and that sentence is expressed with complete passion) To me, the length of my life is not as important as quality of it.

Maybe you have a different aspect on treatment. If you have any insight that would help me understand the benefit of treatment, please share your thoughts. At this point, I am considering forgoing treatment altogether.

Thank you for your time.

Response from Dr. Young

Thanks for your commentary-

I share your view that it really is quality of life that governs our outcomes. It is clear that for some persons, HIV medications do come with side effects, effects that can adversely affect the quality of life.

On the other hand, there are many (and I'd say a large proportion) persons on their initial drug regimens who tolerate their medications with little or no side effects.

The goal of therapy, as I see it, is preventive medicine. The goal therefore is balancing the risks of medications (possible) to the risks of advancing HIV disease (definate and life threatening). At some point, the balance of risks favors treatment- though this balancing point is very individualized. Also understand that the science of treatments continues to get better, so that the complications that we saw in the past, hopefully, will not be seen (with the same frequency) in the future.

Hope this is helpful for you. -BY



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