Commonly Asked Questions Regarding Management of Patients with HIV and AIDS

Q: What is the Difference between HIV and AIDS?

A: The term HIV stands for human immunodeficiency virus. It is transmitted primarily through sexual contact or blood transfusion. HIV weakens the immune system, and if untreated, eventually progress to AIDS.

The term AIDS stands for acquired Immune deficiency syndrome. It occurs when a person's immune system is profoundly weakened by HIV. Persons with AIDS are at high risk for developing and dying from various types of infections and cancers.

Q: What are the Treatments for HIV/AIDS?

A: Treatment for HIV/AIDS involves two components: 1. Prevention of AIDS-related infections, 2. Treatment directed towards the HIV virus.

First, preventing AIDS-related infections is cost-effective and increases a patient's life expectancy. Prevention of infection involves taking "prophylactic antibiotics" and receiving vaccinations.

Second, treating HIV itself may result in improved immune function, enhanced quality of life, and increased life expectancy. Treatment involves taking combinations of anti-retroviral medicines (i.e., taking several different types of HIV drugs daily).

Q: How Has Treatment for AIDS Changed in the Past Five Years?

A: Previously, AIDS patients were treated with single drugs such as AZT (zidovudine) and DDI (didanosine). These drugs were shown to benefit some persons, but many still died from AIDS and its complications.

Recent advances have revolutionized HIV care and resulted in significantly increased life expectancy for patients with early and advanced HIV-infection. Presently, there are several different types of HIV drugs on the market. Furthermore, when HIV drugs are taken in combination, they may decrease the levels of HIV in the blood to undetectable. Patients receiving "combination therapy" have demonstrated dramatic improvements in immune function, quality of life, and life expectancy.

Q: What are the Disadvantages of "Combination Therapy"?

A: Two major disadvantages with "combination therapy" are the inconvenience of taking several medicines throughout the day and the cost of treatment. Patients receiving combination therapy may need to take as few as three pills per day to 12 pills per day at an estimated cost of $12,000 per year. However, several studies have demonstrated that combination therapy is cost-effective and saves lives.

The medicines may also produce side effects such as nausea, vomiting, diarrhea, rash, and neuropathy. However, these side effects are often mild and resolve with time.

Q: When Should Patients Start "Combination Therapy"?

A: The decision to start combination therapy should be made after consultation with an HIV specialist (e.g., Infectious Disease physician).