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Because the immune system is sometimes suppressed, sometimes overactive, and sometimes misdirected in HIV, it makes sense to seek out medicines which might help correct some of these problems. This is easy to describe but difficult to do. Many researchers feel that we don't yet know enough about the immune system to try to regulate it. Some therapies have been shown to influence the immune system in studies, and similar claims have been made about some natural products. There is great popular appeal to the notion that we should somehow "boost the immune system" to help the body naturally regulate itself against HIV. For the most part, this is little more than an empty advertising slogan as there is little evidence that anyone really knows how to do this. Moreover, the body's natural defenses almost always seem to fail in the fight against HIV. Perhaps even more than the other types of intervention, it would be unrealistic to expect this approach alone to solve the problems of HIV.
In developing these types of therapies it is difficult to predict the overall effect because of the highly interdependent nature of most immune functions. Improving one area may harm another. At this point, there is no clear or simple strategy for addressing the defects of the immune system in HIV infection.
Opportunistic Infection Strategy
Once the immune system has failed to a significant degree, it becomes necessary to try to prevent the occurrence of the most common opportunistic infections, or prevent their return after a first occurrence.
OI prevention or "prophylaxis" should be considered when CD4+ counts are in or nearing a danger zone (for example, the risk of PCP becomes high at CD4+ count of 300 or below, and the risk of CMV and MAI increase rapidly when the CD4+ falls below 100).
Careful and timely use of medication can prevent PCP altogether. As the incidence of tuberculosis (TB) rises among HIV+ people, testing and possibly preventive treatment is recommended. Similar preventive treatment is rapidly becoming available for other infections as well.
In advanced HIV disease, an infected person often must try to treat or prevent several different opportunistic infections at the same time. This can lead to difficult choices, since many medications can interact with each other. Four Project Inform publications can help sort this out:
1. Opportunistic Infections Chart
2. Drug Interactions
3. Guide to Gynecological Conditions in Women with HIV
The key to successful intervention is comprehensive inclusion—doing all of the things that makes sense in your individual situation. The biggest mistake is to dogmatically choose one approach over the others. HIV is not a political debate or a matter of opinion—it is a life threatening illness. Every decision about treatment has consequences. Each infected person has little room for mistakes. It makes no sense to bet your life on any single philosophy of medicine.
Available Treatments
Project Inform provides information on the use of the best proven HIV treatments. These and any other treatments should only be used under the care of an experienced physician. We encourage patients and physicians to enter into collaborative relationships with shared responsibility for achieving and maintaining health. Treatment should always be accompanied by monitoring which evaluates the success or failure of treatment. Both patient and physician should be prepared to adjust strategy based on the results of the monitoring process. This model of flexible, monitored treatment used in the context of a collaborative doctor/patient relationship is the key to managing HIV as a chronic illness.
Complete information on treatments currently viewed as helpful is readily available, along with discussion papers on related topics. Just ask for the basic "treatment package." The latest information on these and other important treatment issues is available through the Project Inform Hotline.
The Bottom Line
· HIV Infection is not a death sentence; you'll be OK for quite some time, no matter what happens.
· You can gain power over HIV by learning how it operates.
· Learn to monitor your health; understand the common lab tests.
· Get acquainted with the Project Inform 5-step model.
· Get informed about your treatment options.
· Develop a treatment strategy that makes sense for you.
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Comments
HIV and AIDS Min Arot | Aug 25th, 2003
You have written an excellent text that is informative without being too technically for the non-scientific minds. I wish that you would get an opportunity for wider dissemination of the article in african journals and media so that more people may know these pertinent details about HIV and AIDS. There's also a French journal called Remaide which specializes on HIV and AIDS which could publish this article. Thanks and all the best.
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