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immune system
Jun 8, 2003

Hi Doctor Young

1. In one of the questions you have answered that HIV makes some permanent damage to the immune system (though it is not life threatening). Can you please tell us what is that damage? What are we vulnerable to because of those damage and what we can do to avoit it? 2. All the combination meds are preventing the reproduction of HIV. that means less virus and even that virus is beeing killed off by tcells right? then some point in time there will be no virus right??

( I really appreciate your answers, as my docter spends harly 5 minutes with me to answer all the questions!!)

Response from Dr. Young

Thanks for your question. Sorry to hear that your doctor does not have the time to answer your questions fully. I would press him or her to provide you with your answers-- this is the best way to make sure that you have access to informed decision making about your health matters.

To answer your questions--

HIV appears to cause the deletion of the very immune cells that are essential to control HIV infection. This deletion or extinction of the so-called HIV-specific cellular immunity seems to happen very early in the infection, and unlike other aspects of the immune response, is not restored well after the starting of antiretroviral therapy.

Really, the only thing to do to avoid this specific extinction of this part of the immunity is to recognize and treat HIV infection during the acute phase.

You're correct in the statement that medications prevent the reproduction of HIV-- indeed the idea that we could prevent new cells from being infected led to the initial idea that we might be able to eradicate the virus from an infected person. Unfortunately, some of the infected cells live for many, many years-- such that one estimate says that we'd have to fully suppress the virus for DECADES before hope of eradication. In practical terms, this is just not going to happen-- hence, we need alternative strategies if we are going to look realistically at eradicative therapy. BY



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