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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
          
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medicines good or bad
Sep 30, 2003

If the medicines for HIV keep you alive for say 10 to 15 years on 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. The alternative would be to take meds and damage my colon, heart or other organs with these poisons, and gain a few years (if any). It seems that the whole HIV/AIDS continuum 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 +. It could have guests debate all the issues surrounding HIV in America today.

Response from Dr. Conway

I'm all for a show on TV. Knowledge is power and debating the issues out in the open is a good thing.

Your points are well taken. None of the medications currently available to treat HIV infection constitute a cure. The long-term side effects, in some people, are quite real. That is why the current guidelines suggest that we wait to start HAART until we are certain that the immune system is on an irreversible path to deterioration. This is generally thought to be at a CD4 count in the 200-350 ranges. If this criterion is used, we can allow those who may not need the treatment to avoid it (and its side effects!!!). We can also provide the treatment to those who really need it and who may actually respond to it in such a way as to remain alive for many, many years (quite likely much more than 10!!!)

Until a cure for HIV is found, it is possible that the current types of medications will transform HIV into a chronic, manageable disease. By targeting the patients who will gain most benefit from treatment, we will avoid toxicity in the patients who may be able to stay healthy without the use of the drugs.

How's that for the first episode of the TV show?



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