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re:one more
Sep 2, 2003

Hi Dr. Young,

One of the reasons this site is such a valuable resource is the fact we have experts like yourself to answer questions. The immune system is just so complicated, and unfortunately I have always felt it is fertile ground for snake oil salesmen esp on the internet. I dont mind if they propose a healthy lifestyle: quitting smoking, eating raw garlic, exercising, etc. But it is when they downplay the significance of the successes of HAART that I get angry. Statistics do not lie. There has been a dramatic decrease in aids realted deaths in the usa since the advent of treatments. The fact that these treatments have targeted a virus that mutates and hides is unparalleled in the history of medicine. Period.

Will those with hiv have to take medicine all of their lives? From the scientists I hear this is likely. But let's put it in perspective. There are millions of people with chronic illnesses who live full, happy lives into their grey years. Those with heart disease, diabetes, Crohn's etc. All of these people take medicine every day. Some take many pills, most with dietary restrictions. Adherence by the pateint is an integral theme in the treatment of ANY disease. Frankly, I think ten years from now we will treat HIV more like HSV. As a matter of fact I was once told by a geneticist that all of us have viruses in us since infancy. While we accept it is a permanent part of our cellular makeup, so long as it is supressed there is no problem. Do you agree? Perhaps those afflicted will go to the doctors for routine blood tests and injections. Or maybe we will have ultra-specific acting drugs, flagging the virus for destruction, and ways to prevent the virus from "locking" into the body's cells and hijaking them. Perhaps these therapies will be the future. As scientists study the genetic makeup of non-progressors, and more money is invested in biotech developments, the years ahead will be facinating. All in all I doubt the "cocktail" will still be the gold standard of treatment in the developed world for years to come...

There really is no way to predict where we will be if you read this in 2013, however. I remember Dr. Ho was on an online interview saying no one, even the most optimistic virologist could have predicted we would be discussing a novel approach like "entry-inhibitors" only ten years after the introduction of Protease inhibitors. Then again, many on his team were sure that the triple therapy was able to wipe out the virus. They didn't know about the resovoirs. Now we do.

I hope you continue to parlay your knowledge, optimism, realism and most of all humanism to all of us Dr. Young. It is appreciated.

Response from Dr. Young

Thanks for your comments... I agree entirely, and it's nice to hear from persons who can support the idea that medications make a difference. BY

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