why are people still dying of AIDS?
May 14, 2008
If the HAART is very effective, why are thousands of people die every year of AIDS in resource rich countries such as the US? Is it mostly due to lymphomas? Would you agree that HAART has not decreased the probabilty of getting lymphomas in hiv infected individuals significantly. Are most of us eventually bound to die of such cancers even though we have access to treatment? I am a very young guy who has been recently infected, trying to learn as much as I can about the disease yet all I am getting is conflicting information on the prognosis.
Response from Dr. Henry
Deaths in HIV+ patients in the US are due to a number of factors. Many patients still present late with AIDS defining conditions that remain difficult to treat (average CD4 count when starting HIV meds in US hovers around 200= AIDS range). Many patients don't tolerate or don't take effective HIV medications. Another group of patients has been treated for a long time (even prior to availability of good HIV medications used in combination)so developed resistance to most medications so finding an effective regimen is difficult. A few AIDS defining events such as lymphoma have been less impacted by effective therapy and contribute to persistent AIDS related deaths. A growing and perhaps the largest cause of death in HIV+ patients in US are non-AIDS events such as heart diseae, cancer, kidney disease, and liver disease (often due to hepatitis C). For persons with access to good care in the US who take medications faithfully the prognosis is excellent for many decades of good health from the HIV perspective. If the CD4 count on treatment consistently achieves and maintains a level > 500 then the health outcomes for an HIV+ person ican be similar to the general (non HIV infected) population. KH
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