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efficacy of HAART

May 17, 2008

Dear Dr. Young, I read in a recent New York Times article that in 2007 approx. 5000 people died in the US because of AIDS. Isn't this a very high number? I am in my 20s, recebtly infected. Both my doctor and the doctors in this forum are saying that the life expectancy of a hiv positive individual should be near normal. Yet, losing 5000 people in one year makes me doubt the effectiveness of the therapy. Would you have any comments on that? Best wishes..

Response from Dr. Young

Thanks for your post.

HIV therapies are highly effective, but HIV+ persons have to know that they are infected and have access to care and medications.

I'm not exactly clear as to which dataset your "5000" number comes from, but it is clear that HIV+ persons do die. For those under care and on medications, the death rate is a very small fraction of what it was in the pre-treatment days and indeed, our CDC-sponsored analysis suggests strongly that the causes of death has shifted from HIV-related to non-HIV-related causes (like stroke, liver disease, cancer, suicide and heart disease).

Unfortunately, many persons receive their first HIV diagnosis with active, advanced AIDS complications or fail to receive care for months after the positive test. Both are situations that significantly increase the risk of complications, and as your citation suggests, death.

So, in my opinion, the real issue isn't the effectiveness of therapy, but rather the effectiveness of our testing and access to care programs. Until we move towards universal testing and access to care, we'll still see persons fall through this potentially lethal crack.

Thanks for reading.


Cholesterol and Atripla
To medicate or to wait (that is the question)

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