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Protease Inhibitors and Living with HIV/AIDS
Jul 16, 1998

Just wondering, is there a train of thought that protease inhibitors may ultimately prevent the possibility of AIDS occuring and basically have people living with HIV for an entire lifetime? Upon initially beginning treatment for hiv is it possible to maintain one's full-time job or does it almost always require one to stay at home. Does this vary with persons and with age. . .Can you explain what is antiviral therapy? How soon should one follow it and how effective is it?

Response from Mr. Sowadsky

Thank you for your questions.

When it comes to the protease inhibitors and other antiviral therapies, there is good news and bad news.

The good news:

1) Treatments have been shown to significantly improve the quantity of a persons life. People taking the latest treatments are now living much longer. With improvements in treatments, we have now seen a significant drop in the death rate due to AIDS (in places where drug treatments are available).

2) In many cases, treatments have now significantly improved the quality of a persons life as well. Many people can now continue to work and can continue to lead productive lives, despite their illness. There have been cases where a person was too sick to work, and with the latest treatments, they clinically improved to the point where they were able to return to work.

The bad news:

1) Many people do not have access to these drugs, especially in developing nations. In addition, these drugs are extremely expensive, and many people cannot afford them.

2) These drugs have to be taken exactly as prescribed. The dosing schedules can sometimes be very complicated and confusing for people to follow. Many people find it difficult to keep up with the rigorous dosing requirements. If these drugs are not taken exactly as prescribed, HIV can develop resistance to these drugs. When HIV becomes resistant to these drugs, the drugs may no longer work, and a person would have to change to different medications. There are now strains of HIV that are resistant to multiple antiviral drugs.

3) Many of these drugs cause side effects that can be difficult for some people to deal with. Some people stop taking their medications due to the severity of the side effects. For more information on this topic, read the posting Drug Holidays: Are they Worth It?.

4) Although these drugs benefit many people, they do not help everyone. Even with these drug treatments, some people are still too sick to work (because of the illness itself, and/or because of drug side effects). These drugs can slow down the disease, but they cannot stop it.

Because of the problems associated with drug resistance, side effects, access to drugs, etc., we cannot call this a fully manageable disease at this time. Although present drug treatments do significantly slow down the progression of the disease in many people, they do not stop the disease, nor cure it. At this time, we cannot say what the long-term benefits of these drugs will be, since these drugs have only been around for a few years. We cannot say at this time if a person can live a lifetime with these drugs (and the disease) or not. Only time and experience will answer that question. However, we can say that many people have benefited immensely from these drugs, both in improving the quantity of their life and the quality of their life as well. But there are still many problems to solve, especially as it comes to simplifying complex dosing schedules, and dealing with the ongoing problem of drug resistance. We definetely have a lot to be optimistic about, but we should also be cautiously optimistic. We certainly have come a long way, but we still have a long way to go.

For the latest information on treatments, including the best time to begin therapy, how effective it is, etc., visit the Treatment Forum here at The Body.

If you have any further questions, please feel free to call the Centers for Disease Control at 1.800.232.4636 (Nationwide).



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