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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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Dying from Something Else
Sep 22, 2004

It was good to read your comment to another patient that you believe the recently diagnosed are more likely to live on to die from something else. HAART has helped people who once would have progressed rapidly to AIDS and death. However, comforting advice usually talks about the success of "those who tolerate" the medications and those who can reduce their viral load. Fewer people die of AIDS but it seems harder to get information about how many more people are dying early from liver problems or heart attacks or other problems from the medications. It is disturbing that the emphasis of new drugs seems to be mainly on providing new medications after one fails the older ones, or giving us fewer pills to take, but less on finding ways to keep us from dying from the side effects of the medications.

It is encouraging that there is research on gene therapies that might have more long lasting effects, but it seems that trials of these are underfunded, and if one person dies from them they are shut down or delayed, whereas when larger numbers of people die from a drug this is treated as a necessary risk as long as many more people benefit from it.

Also are there any alternative therapies that you would consider trying during the asymptomatic period, or if a patient still has a high viral load on conventional treatments or has life-threatening symptoms/lab results on conventional treatments?

Response from Dr. Conway

One of the most encouraging things about newer treatments is that they are not only easier to take (less pills, less often) but are relatively free of side effects. This includes short-term and long-term side effects, such as elevated lipids, liver problems and problems with heart attacks. This is actually a major focus of the development of new drugs and this should hearten us.

Gene therapy is potentially exciting, but I do not see it moving forward that quickly. I prefer to focus on what we have now, and be very happy if new stuff that can cure HIV comes along.

As for alternative therapies, I focus on excellent nutrition and a balanced diet to start. Some other things (diet supplements and the like) may yet emerge from clinical testing, but there is nothing definite yet. My feeling is that just because it is labelled "alternate" doesn't mean we don't need to test it properly to make sure it works...

Anyway, I stick to my message of cautious hope...

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