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HIV vs. Diabetes

Mar 13, 2006

Dear Doc,

Just curious and hope you will answer. If HIV is a chronic disease much like diabetes and treatable (and I know it is) then why do people immediately start asking questions about life expectancy when they find out they are HIV positive or have to undergo counseling. Unlike diabetes, where people just accept it and live on. Cant wait to hear a professional opinion.

Response from Dr. Frascino


Although HIV disease is becoming more manageable than in the past, the comparison to diabetes is probably overly optimistic. The first effective HIV therapies hit the market in mid-1996. These medications were potent, but also difficult to tolerate, due to side effects and toxicities. Dosing schedules, food restrictions and medication-storage requirements also made adhering to these medications difficult. The virus also has continued to evolve and subsequently various viral strains have developed resistance to the new medications almost as soon as they came into general use. Add to that that we are continuing to see unanticipated complications related to the new therapies both metabolic and morphological. For many people with HIV/AIDS it is not a case of "just accept it and live on." The challenges posed by a virus that attacks and destroys one's immune system cannot be overstated. We don't really know what the life expectancy of someone with HIV/AIDS is because the illness is variable from person to person and our ability to mange it effectively is still evolving. No doubt things are improving, but we still have a long way to go before HIV can realistically be considered a chronic manageable illness like diabetes.

Dr. Bob

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