To Our Readers

By John Flanagan

Saturday, August 10, 1996


AIDS, there's still no cure

AIDS. It's the number-one killer of adults between the ages of 25 and 44. There's still no cure, but The FDA has approved three drugs called protease (pronounced pro-tee-AZE) inhibitors. These drugs stop HIV virus reproduction by attacking an enzyme, protease, that has to be present for it to happen.

Dr. Arthur "Ace" Johnson of Tripler Hospital was one of a panel of AIDS experts who spoke to news people this week after returning from the 11th International AIDS Conference held last month in Vancouver, Canada.

Johnson said the new drugs now make it possible for someone with HIV to have a normal life span ... IF.

These days, it seems there's always an 'IF.' In the case of AIDS, there's lots of them:

IF the patient has access to the drug. 90 percent of those infected with HIV live in countries where it will be virtually impossible to make the new drugs available to any significant degree.

IF the patient can afford the drug. The cost for treatment is about $25,000 a year, barely tolerable for patients with good private insurance coverage and unaffordable for most patients, who tend to be uninsured or living on society's fringes.

IF a rigorous medication schedule is followed to the letter. Treatment can involve taking as many as 20 pills a day on a strict timetable. If the schedule isn't followed, the virus could mutate, forming a drug-resistant strain.

IF the drug companies stay ahead of the mutating virus. FDA-approved drugs can be prescribed by any licensed doctor. It's a safe bet that a few physicians will over-prescribe and/or under-supervise patients, speeding the development of HIV strains resistant to protease inhibitors.

As with antibiotics, which have to be reinvented continually to be effective on other viruses, the new drugs can be rendered useless. That's a danger to everybody, not just the person who didn't take the pill.

IF the patient can endure the side effects. Many patients can't physically cope with the nausea, vomiting and diarrhea that are common physical reactions to the treatments.

In Hawaii, there are fewer than 2,000 known AIDS cases, but Nancy Kern of the state health department estimates that there are between 3,000 and 5,000 people who are HIV positive. In other words, 60 percent of those carrying the virus don't know they have it.

Testing is not yet part of the routine diagnosis of sexually active sick people, Johnson says. "Most patients discover they are HIV positive only after they present some kind of AIDS symptom."

The disease is treatable, and most important, preventable. Needle-exchange programs, education, early diagnosis and awareness are all ways that AIDS can be controlled ... IF.

IF we all realize there's still no cure for AIDS.



John Flanagan is editor and publisher of the Star-Bulletin. To reach him call 525-8612, fax to 523-8509, e-mail to publisher@starbulletin.com or write to P.O. Box 3080, Honolulu, Hawaii 96802.





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