The Truth About a Cure

Brad Spellberg, MD

Current Treatments of HIV
A dozen or more drugs are currently available for treating the human immunodeficiency virus (HIV). These include the widely-known AZT and a variety of similar drugs called "reverse-transcriptase inhibitors" that destroy HIV by preventing it from copying itself within the body. The problem with drugs like AZT is that the HI virus is capable of becoming resistant to them, sometimes in a matter of months. Patients who are treated with such drugs usually get better for a while, but the drugs can quickly lose their effect when the virus mutates in its fight to resist them.

In 1995, however, an entirely new class of drugs called "protease inhibitors" came on the market. Protease inhibitors, in combination with reverse-transcriptase inhibitors, have revolutionized management of the HIV infection. Before these drugs were available, people infected with HIV had little hope of long-term survival. The risk of death from HIV infection and, ultimately, AIDS, was estimated at 90 to 95 percent.

With the advent of protease inhibitors, there is now legitimate reason for hope. "Cocktail therapy"-utilizing combinations of protease inhibitors and reverse-transcriptase inhibitors-has been shown to have a significant impact on HIV, and, as a result, many patients are now capable of completely suppressing viral replication within the body. Furthermore, with the use of three or more drugs at the same time, HIV's ability to mutate and cause drug resistance is substantially inhibited. What's unfortunate is the fact that some strains of HIV are resistant even before an infected individual begins taking the medication.

Most of the protease inhibitors have somewhat unpleasant side effects, including nausea, vomiting, diarrhea, and kidney stones. There is also a huge expense involved with taking all the required medicine. As a result, some patients stop taking their medicine. With patients taking a dozen or more pills at specific and various times during the day, the regimen can also be confusing and difficult to follow. It is not uncommon for people to periodically forget to take the proper drug at the proper time. Unfortunately, the lack of a strict regimen is all HIV requires to resume its damage. Unless patients adhere faithfully to their treatment schedule, the risk of HIV developing resistance to the drugs is high.

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