|medicines good or bad
Sep 6, 2003
If the medicines for hiv keep you alive for say 10 to 15 years average, With a multitude of side effects why take them. Here is my analogy. I get hiv today and take no meds i will live about 10 years give or take a few. with no debilitating side effects and additional damage to the rest of my body. Alternative take meds and damage my colon, heart, other organs with these poisons. and gain if any a few years. It seems that the whole hiv aids continum has to be understood and weighed out. The hiv business has to change and quit making a mockery of the people it serves. There should be a show on tv called hiv +. Have guest on talk in open debate all the issues surrounding hiv in america today.
| Response from Dr. Henry
I share much of your frustration. We certainly have much to learn about out to optimally use our current HIV meds and how to develop better ones. I also remember the days before the meds were available. In the early 1990's I was having one of my patients die weekly after developing an average of 4.5 AIDS defining complication. The suffering was immense. With the advent of effective combination therapy the death rate in my clinic dropped almost 90% in 1996. Even more miraculously, patients who were on their deathbed recoved their health and many are still doing well today. The HIV medications clearly can have a huge benefit but the benefit is only clear among those with AIDS-related illness or CD4 cell counts < 200-250 cells/mm3. For persons with CD4 counts >> 250 then the risk for side effects and/or resistance may often outweight the protection against AIDS/death. Each patient has unique features involving the change in the CD4 and RNA levels over time,other medical problems, personal philosophies,etc. It is unusual for me to see a patient that we can't find a combination among the dozens available that isn't well tolerated though it can be a trial and error proces which is frustrating. I have many patients who are not on therapy who are still doing well (usually those with CD4 counts > 200). Thanks for sharing your viewpoint and call to further action. Docs, patients and the public mistakenly believe that we have great drugs and that we know how to use them (I disagree with that statement). Interest in studies has dropped off markedly due to that mistaken perception. KH
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