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Long term effects of HIV
Jul 29, 2012

In her recent interview in the July edition of POZ magazine ('The Cure Hunter'), Françoise Barré-Sinoussi, mentions that people are not often aware of 1) the long term effects of HIV infection (on treatment) and 2) incomplete immune reconstitution. Could you talk about those things a little so we understand better?

Response from Mr. Vergel

As you know, we have made great progress in HIV. Most people who adhere to a medication schedule can achieve undetectable HIV viral load and improvements in CD4 cell counts.

Many of the newer HIV medications (mostly approved after 2003) have a lot fewer side effects than the older ones. But we still worry about long term effects on bone density, kidney function, cardiovascular risks, and cognitive dysfunction as we age. Also, some people may not have full immune recovery even after years on HIV medications. Whether or not those with incomplete immune recovery will live as long as those who have high CD4 cells still remains to be seen. Also, there seems to be an underlying immune activation and inflammation in patients with successful viral control even after years on treatment. We are not sure if that immune activation and inflammation will translate into increased complications as we age.

Another factor that justifies a cure is that HIV medication access in the world is still unacceptable even after 31 years of AIDS.

Nelson



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