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Re: Definition of a full blown aids
Jan 10, 2005

Dear Dr:

I refer to your email on Jan 7,2005 regarding the subject:

What is the purpose of that definition, when with proper treatments, many Aids patients can have their T4 cell level recovered to above 200, and the various OI can now be effectively treated ? My main concern is that, having been branded as an aids patient, one would be emotionally devastated and psychologically defeated, this impact would remain forever.

Tony.

Response from Dr. Pierone

The definition of AIDS was put in place many years ago as a means to differentiate between someone who simply had HIV infection versus someone else with HIV infection who was also showing signs of immune deficiency. Knowledge was limited then and this case definition was put into place for epidemiologic (epidemic tracking) reasons. One could make an argument that it is time to use different terminology and just say HIV infection or symptomatic HIV infection. The use of AIDS versus HIV infection supports the illusion that there is some sort of special threshold, while biological evidence indicates that the natural history of HIV infection follows a continuum of progressive immune dysfunction.

I think you are right that some people with HIV infection suffer emotionally when they are given a diagnosis of AIDS. The response to this diagnosis though is not necessarily psychological defeat; most people are very resilient, they bounce back, get on medications, reconstitute their immune systems, and get on with their lives. Thanks for posting.



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