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caracteristics of illness
Jan 18, 2003

I am trying to understand the caracteristic of this illness and I have got some questions. I hope somebody can give me the right answers. 1) I think all of the pills and even Haart treatment is only helping to decrease virus load and increasing cd4 cells in the blood. Is there any effects to lymph system of these pills or not? I mean can we effect to lymph system and even to brain with these pills or are we only being able to imporve the blood? 2) If this illness is effecting to human body because of cd4 cell lackness, I believe the future of the tratment is lying at the synthetic cd4 cell production. Is there any reasearches about this subject? And can you tell me which part of the body is responsible for the production of cd4 cells? Does it liver? 3) Does side efects of the pills are effecting all of the pattients? I mean somebody who get the treatment, will certanly has got other illnesses because of these pills in a long term or not? Can we say that the body can bear to these pills maximum 20-25 years? If it is true can we think that to start to the treatment a little later can be advantageous?

Response from Dr. Wohl

You raise some important issues. Current HIV therapies have been demonstrated to not only make the lab tests we order look better but also have been clearly found to extend life and quality of life. In the US, Europe and Australia, death rates from AIDS have dropped sharply since new HIV drugs became available. They absolutely save lives.

Studies show that taking a combination of HIV medications reduces HIV levels not only in the blood but in the lymph nodes as well as in the genital fluids and spinal fluid. So their effect is not limited purely to reducing HIV levels in the blood.

Expanding the number of CD4 cells in the body makes sense since that is what people living with HIV need, more CD4 cells. The problem is that CD4 cells are also what HIV eats for lunch. So unless there is good control of HIV in the body, adding more CD4 cells may not help and can possibly hurt (think gasoline + fire). Making synthetic human immune cells is not something that I think science has figured out how to do. However, there are drugs that people can take to increase their CD4 cells such as IL-2. Again, this is something that is only administered (in research settings) when HIV control has been achieved.

Lastly, despite a lot of talk about side effects, most patients taking HIV medications actually do not experience major problems. The risk of drug side effects though certainly has to be balanced with the risk of side effects from HIV itself. Currently, we are starting HIV therapies later than we used to. When even better tolerated drugs become available, it is likely we will return to hitting the virus hard and earlier than we are now. DW

general information
Acute HIV

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