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mortality rates
Jun 9, 2008

Hi Dr. We've all heard how the mortality/morbidity rates started to decline in the late 90's, when the trio drug cocktail came into vogue.

Isn't it reasonable to think that the change is at least in part due to that fact that the highly toxic AZT drug was decided to be prescribed less, beginning at this time period?

And this begs a further question. Those fellas back in the early 80's, those first few who were sick, and essentially our first test cases to realize something was happening... They were already on death's door, being that they were worried enough to go to the doctor. So, in presense of their symptoms, they already had AIDS.

What studies indicate that a healthy hiv+ person will turn to AIDS? Have studies tracked healthy, non-med taking people and conclude it will always turn to AIDS?

I'm not denying a hiv/aids link... But it seems like Dr.s don't even like to admit that possibility that some hiv+ will never get AIDS. You'd think that they'd be encouraged by such a prospect. Why conclude that 'non-progressors' have some genetic advantage, rather than them simply taking great care of their bodies?

Response from Dr. Frascino

Hello,

Yes, the "studies" that you are wondering about have in essence been done by history. HIV was recognized in 1981. Effective antiretroviral therapy did not become available until mid-1996. We had 15 years to monitor exactly what happens to HIV-positive folks not on therapy in this country. In addition, antiretroviral therapy is still unavailable to millions of people who need it in the developing world. Consequently we now have over a quarter of a century of direct observation.

As for your idea of "simply taking great care of their bodies," obviously you're not the first one to come up with that idea. By the way, don't you think Rudolf Nureyev, Rock Hudson and Magic Johnson have taken great care of their bodies? And what about yours truly? I certainly know how to take care of my body. (After all, I was runner up in a bear-chest calendar competition a couple years ago!) And I watched my immune system deteriorate off medications in the early nineties (prior to the development of HAART).

It is indeed true some folks don't progress to AIDS. Those individuals are extremely rare. We continue to monitor these folks in clinical trials. Genetic advantage is one mechanism that may help to explain the rare phenomenon of long-term nonprogressors and elite controllers.

I'm glad you are not denying the link between HIV and AIDS. However, your concerns have clearly been influenced by AIDS-denialist theories. I strongly advise you to review the information on AIDSTruth.org. I believe you'll find it enlightening. In addition, consider viewing the PBS documentary "The Age of AIDS." You can Netflix it! It chronicles the first quarter century of the AIDS pandemic and addresses many of your concerns.

Dr. Bob



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