Eventualy Bound to fail??
Jan 19, 2006
Dear Doctor; Thank you for all of your brilliant work here and your continued efforts to help people facing such calamity.
After reading much of this forum and the website, it seemed that despite its success, HAART is eventually doomed to fail, due to resistances, mutations, adherence issues, that over time, say maybe 10 or 20 or some cases 25 years everyone infected will almost certainly die?? that despite its success in brining down the death rate due to AIDS, all it has managed to do is prolong the process and make it ever so expensive for the patients in the process?? Any thoughts or comments on that? and what you believe the future holds for patients, both newly infected and those already on long term treatment. Also your thoughts on when a cure might be possible? and that would the presence of mutations and resistant virus make a cure even impossible to work for those already infected? Also, would the development of a successful vaccine also mean simultaneously that a cure is also avaialable? One best exemplified "if there is a disease, there exists a cure"
Response from Dr. Henry
I don't think that current HIV treatment is doomed to fail. Patients who suppress on their first regimen with no resistance have a very low risk for failure in subsequent years. Virologic failure rates for fully suppressed patients have been averaging from 1-5%/year with more current regimens which translates into very long clinical control. Virologic failure doesn't = clinical failure so often even if the regimen fails a different regimen can often be found to re-suppress the virus and maintain immune funcition. Since the virus can remain dormant but alive for perhaps 50+ years cure is very difficult since the virus can reactive once treatment is stopped. Efforts are still underway to cure HIV but realistically nothing in the pipeline looks highly promising. KH
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