HIV treatment a mixed blessing Health Lori Swick The treatment of the human immunodeficiency virus (HIV) has changed immensely. New potent drugs are prolonging the lives of thousands of patients infected with the virus - more than 40,000 in Canada alone. It is no longer a disease you have to die from but rather one to live with, just like diabetes or high blood pressure. Long gone are the days when we had only one drug with which to treat HIV. There are now over a dozen medications available, designed to attack different points of the virus lifecycle. But the new drugs are a mixed blessing. Side effects, onset of new diseases caused by the treatment for HIV and the immense pill burden are new problems that many individuals with HIV must adapt to. The lives of many patients have become governed by their drug ``cocktails,'' which for some patients involves as many as 40 pills a day. New scientific research has revealed that starting treatment before the disease gets too advanced provides a better prognosis. Similar to cancer, once the disease has spread and attacked other systems in the body, it is harder to get rid of. One of the major barriers to effectively treating HIV is that most people do not feel sick at the time that they are offered anti-HIV medications. In fact, it is only after starting the medications that they begin to feel sick. Unpleasant side effects from the medications range from nausea, vomiting and diarrhea to hallucinations and painful tingling in the fingers and toes. Patients with HIV have also been developing abnormally high cholesterol and lipid levels and even diabetes, creating suspicion that some of the drugs may be the culprits. There are additional medications that can be used to treat side effects, but along with pain relievers, vitamins, antacids, anti-fungals and other antibiotics used to fight off infections, pill counts can become extraordinary. Another problem is that once someone has begun treatment, the virus becomes aware that they are launching a counterattack and starts trying to mutate in order to overcome the medication. This means that the virus is trying to get stronger, and any interruptions in therapy or even occasional missed doses can afford the virus a chance to develop resistance to the medications. The goal is to strive for perfection and never to miss a dose of the medication. Much is being done to help patients with HIV manage their new lifestyles and incorporate their medications. Clinics, such as the Immunodeficiency Clinic at the Toronto General Hospital, have specialists available to help patients organize pills, manage side effects and prevent complications associated with the medications. Despite the advances made in the treatment of the disease, new cases of HIV are still being diagnosed at an alarming rate. More women than ever are being infected, despite increased efforts to promote safe sex and intravenous drug use. New drugs provide great hope for treating this destructive disease, but as long as this remains an incurable disease, efforts should continue to be made to prevent HIV. For more information about specific medications and supports available contact the Toronto General Hospital HIV Web site at http://www.tthhivclinic.com. ------------------- The views expressed are those of the author, a practising doctor of pharmacy. The Health column appears Fridays in the Life section.
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