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Follow Up
May 29, 2003

Dr Young:

Wow--You answered many questions on May 29. You must gave gotten a jolt of energy, or just a little spare time.

I had earier asked about the death rate of persons who are on treatment. Your response indicates that those with a rapid hiv progression might die earlier even with treatment. Do you know why? I can understand if there is drug resistance, but your response suggested to me that even without resistance, deatk may come sooner. That I need some explanation for. Will the meds not stop the disease progression? Kevin

Response from Dr. Young

Kevin--

Yes, a bolt of energy has struck me (actually precious spare time while travelling for work).

The unstated part of my answer relates to the fact that some persons, despite good access to care and medications merely have bad luck (like drug toxicity)or just don't want to be on medications-- I've watched treatment naive persons simply refuse therapy and die from rapidly progressive AIDS.

So, I was speaking from a population- or group-based perspective.

If someone truly was able to comply (adhere) to a well thought out treatment regimen, I'd think that rapid progressor or not, that the likelihood of treatment success (and therefore immune health) is very, very good-- yes, disease progression should be halted. -BY



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