The Truth About a Cure

For many years, HIV and AIDS were synonymous with a death sentence, yet now there's lots of talk of a possible cure. What truth, if any, lies behind this? The truth is that there still is no cure for HIV, but understanding the different ways of treating the virus can help your chances of staying healthy longer.

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.

The current risk of death in patients who successfully tolerate cocktail therapy is unknown. What is known is that up to 50 percent of patients "fail", or are unable to tolerate it. However, in those patients who are able to tolerate cocktail therapy, some pretty remarkable results have been achieved. The virus has been suppressed to below detectable limits in the blood of a majority of such patients, and except for frequent visits to the doctor, a regimented medication schedule, and risky side effects, these patients are able to live relatively normal lives.

One concern is that when people's lives return back to "normal", they stop taking their medication. Multiple studies have shown that patients who stopped taking their medications because the HIV in their blood was undetectable always relapsed. HIV is capable of hiding in the lymph nodes of the body so we don't necessarily see it in the blood. Some scientists feel that taking cocktail therapy for a long enough period of time (estimates range from three to 30 years) might cure some people with HIV. As of right now, though, there is no evidence to this effect, and no one has ever been cured of HIV.

The Future of HIV In the future, it might be possible to cure HIV, but for now, holding it at bay is the best we can hope for. Vaccines are currently being developed by scientists both to prevent infection in the first place and to boost the immune system to help destroy HIV after infection. But none of these vaccines has yet been proven to work effectively, and none are close to widespread availability. Until a successful vaccine is created, abstinence or safe sex-and staying away from intravenous drug use-are the best ways to protect yourself from HIV.

For a testing or treatment center, contact:

National AIDS Hotline (800) 342-AIDS (2437)

HIV/AIDS Treatment Information Service (800) 448-0440