AIDS
Alternative names:
acquired immune deficiency syndrome
Treatment:
There is no cure for AIDS at this time. However, treatments
are available that can improve the quality of life of those
suffering the infection.
Antiviral therapy suppresses the replication of the HIV
infection in the body. A combination of several antiretroviral
agents, termed Highly Active Anti-Retroviral Therapy (HAART),
has been highly effective in reducing the number of HIV particles
in the blood stream (as measured by a blood test called the
viral load), and, as a result, increasing the CD4 positive
T lymphocyte count. Although this is not a cure for HIV, and
people on HAART with suppressed levels of HIV can still transmit
the virus to others through sex or sharing of needles, the
treatment shows great promise. There is good evidence that
if the levels of HIV remain suppressed and the CD4 count remains
high (>200) that prolongation of life can be achieved. However,
HIV tends to become resistant in patients who do not take
their medications every day. Also, certain strains of HIV
mutate easily and may become resistant to HAART. When HIV
becomes resistant to HAART, salvage therapy is required to
try to suppress the resistant strain of HIV. This is often
not successful, unfortunately, and the patient will usually
develop AIDS and its complications.
Treatment with HAART is not without complications. HAART
is a collection of different medications, each with its own
side effect profile. Some common side effects are nausea,
headache, weakness, malaise, and fat accumulation on your
back and abdomen. Any doctor prescribing HAART should be carefully
following the patient for possible side effects associated
with the combination of medications being taken. In addition,
routine blood tests measuring CD4 counts and HIV viral load
(a blood test that measures how much virus is in the blood)
will be taken every three to four months. The goal is to get
the CD4 count as close to normal as possible, and to suppress
the HIV viral load to an undetectable level.
Other antiviral agents are in investigational stages. Growth
factors that stimulate cell growth, such as epogen (erthythropoetin)
and G-CSF are sometimes used to treat anemia
and low white blood cell counts associated with AIDS.
Medications are used as preventive measures (prophylaxis)
to avoid opportunistic infections such as Pneumocystis
carinii pneumonia and can keep AIDS patients healthier
for longer periods of time.
Joining support groups
where members share common experiences and problems can often
help the emotional stress
of devastating illnesses. See AIDS
- support group. .
Expectations (prognosis):
At the present time, there is no cure for AIDS. It has proven
to be a universally fatal illness. Research continues in drug
treatments for AIDS and vaccine development. Currently HAART
has dramatically reduced the United States mortality rate
due to AIDS by 23% in 1996 and 47% in 1997.
Complications:
When a patient who is infected with HIV, the virus slowly
begins to destroy that patient's immune system. How fast this
occurs is different in each individual. Treatment with HAART
can help slow and even halt the destruction of the immune
system. However, once the immune system is severely destroyed,
that patient is said to have developed AIDS, and is now susceptible
to infections and cancers that most healthy adults would not
get. Listed above (diagnosis section) is a description of
the infections, disease processes and cancers that people
with AIDS develop.
Calling your health care provider:
Call for an appointment with your health care provider if
you have any of the risk factors for AIDS; or if symptoms
of AIDS are present. Law keeps AIDS testing and results confidential.
Your health care provider will review results of your testing
with you.
References:
Bartlett, J.G. 1999 Medical Management of
HIV Infection. The Johns Hopkins Hospital. http://hopkins-aids.edu/publications/index_pub.html.
Centers for Disease Control and Prevention
(CDC) - Divisions of HIV/AIDS Prevention. http://www.cdc.gov/nchstp/hiv_aids/dhap.htm.
Updated Date: 06/22/00
Luis A. Diaz, Jr. M.D., Johns Hopkins Medical
Institute, VeriMed Health Network
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