Thursday, October 29, 2009

Q & A: "The odds of progression to AIDS, and eventually to death, is very high"

A few months ago, you wrote "With HIV, there are few if
any 'mild' infections. The odds of progression to AIDS, and
eventually to death, is very high." I always thought HIV always
led to AIDS and AIDS was always fatal (eventually). Am I wrong?
-- BB

You raise a very important point, and one that is worth
thinking about for a moment. The question as to whether
or not everyone who is infected with HIV will develop AIDS is not
yet answered. Nor is it clear that everyone who develops AIDS
will die from it. There is no denying the devastation wrought by
AIDS, nor how poor the long-term prognosis. But the average time
it takes from infection by HIV to the onset of AIDS symptoms is
so long (11 years or more) and since the disease was only
recognized in the early 1980's, the possibility remains that some
number of AIDS victims will actually survive it. In fact, recent
reports from Australia describe a small number of people who have
had many years of being HIV positive, but who show no clinical or
immunological signs of progression to AIDS. This year has also
seen the development of new medications for HIV that in
preliminary studies show some real promise. The prognosis of HIV
infection is still grim, but there are reasons to be hopeful, and
it would not be correct to say that every case is fatal.

The world is still reeling from the onslaught of HIV disease. It
may sound harsh, but in the end, AIDS is just a disease like
leukemia, cancer, even advanced heart disease, or emphysema. For
most people, when they hear of any of these diagnoses, they also
hear their death knell. Mortality statistics will tell us that it
is just another way to die. But with AIDS, the numbers will add
up frighteningly fast as the pandemic unfolds and AIDS exacts its
gruesome toll on millions of lives lost around the world.

Millions of people are living with HIV now. And make no mistake,
some of them will begin to out-live HIV. It's a matter of
precious time. Those who are HIV positive now have reason to hope
that sometime during their lifetime the prognosis will begin to

-- R. Jandl

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