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best long term medication
Jul 20, 1998

Dear Doctor,

Do you know of any studies looking at people who have lived with their HIV for say, 12 years or more? What medications have they generally taken for them to stay healthy? We keep hearing that these medicines enable people to live longer, but are there any studies that actually ask this question to the people who have lived the longest with their HIV? Thank you for any references.

T M, PhD

Biochemistry/Molecular Biology

Response from Dr. Cohen

Well - there are two ways that we have learned that people who have HIV can live long and healthy lives. First there are those who are what is called long term slow (or non) progressors - who have very low levels of HIV and a healthy immune system even 12 years later. This group has not needed antiviral medication to accomplish this. yes they have been studied - and there are no specific medications nor vitamins that completely account for this - the difference appears to be more based on immune factors that are likely at least in part genetic. However - there are some studies done that show that those who do better over years have higher blood levels of vitamins than those who progress faster - while this does not explain everything about the progression rates, it may still be a factor. Many of the papers on this were authored by Tang or Baum and a good medical search system should locate these for you.

For those who have higher viral loads - yes there are many medications that we have used that have helped people live longer. No single medication takes credit - but a correctly used series of medications has been important for those who needed it. There are many studies of antivirals that show in a 1-2 year period a decrease in death and illness when we use most of our antivirals. To find those papers - you might check the Federal guidelines about treating HIV infection - since they reference most of the work done so far to show that antivirals help. One web site to locate those guidelines is HIVATIS.org.

Hope that helps.

CC



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