The Real Truth About HIV/AIDS-A Request for a Communicative-Dialogue

It has been stated that the first reported case of HIV/AIDS in America was in 1981.  Yes, that’s just 33 years ago.  While as a medical student, I had seen several cases of HIV/AIDS and the complexity of illnesses that patients experience with this disease, it became personal to me when a dear friend, 29 years old just in the burgeoning period of his life, was admitted to the teaching hospital where I, as a fourth year medical student, was in school.  I visited him that day, Not as a medical student covering the service, but as a friend, as he was battling with pneumocystis carinii pneumonia (PCP), and subsequently died from the complicating diseases associated with the HIV/AIDS virus,  I felt hopeless not being able to share positive words with my friend about his ability to get better from this disease, knowing full well that he would subsequently die from this disease.  He was the best pianist that I had ever known, and his interpretation of harmonious cords on the piano keyboard was like none other that I had witnessed before, and I believe others would acknowledge the same.

Another encounter that was dear to me, is when a mother called me about her dying son of 33 years of age, when I started my general practice four years ago.  This mother was distraught and not knowing what to do as her son was battling the last stages of HIV with an encephalopathy  perhaps due to an opportunistic viral infection that destroys the white matter of the brain, and HIV neuropathy.  He was not getting better, having seizure activity and severe dementia as well as loss of motor activity, as I explained to her that she should begin to consider the end of life preparation for her son as she wondered about the continual decline of his health and what could be done.  Those are some of the worse times a physician can experience during a medical practice when there is nothing more that can be done.

I share the above two stories to say while we have come a long way with effective antiviral and other prophylatic treatment and even extending lives for those with HIV/AIDS over these past 30+ years, our efforts should be focused on PREVENTION of this devastating disease instead of promoting expensive HIV testing and Drug Treatment, and SICK CARE OF HIV/AIDS.  This country continues to spend billions of dollars on diagnostic testing and treatment as well as management of this disease.

But the real question is, ” Are we putting fear into patient to receive HIV testing inappropriately?” I would admit that the majority of patients who are initially infected with the HIV/AIDS virus early on do not have specific symptoms, and some may have “a viral syndrome for a few days”, i.e. enlarged and tender lymph nodes, fever chills, night sweats, skin rash, joint pain , etc, which passes on.  In general, when one is infected with a virus, the immune system kicks into gear, and it typically takes a few weeks, maybe even months before antibodies, for instance, against HIV viral particles are detected by clinical laboratory testing.  I don’t fully understand the futility of advising the general public or LOW-RISK patients to get tested for HIV viral antigens through an expensive P24-Antigen/PCR-DNA/RNA HIV test, instead of waiting until antibodies are detected three to six months down the line or longer. It goes without saying that those in high risk groups such as gay-men, multiple sex partners, IV-drug abusers, and those with history of blood transfusion/organ transplant, for instance, or those with partners known to be HIV positive and who would like to undergo post-exposure prophylactic HIV therapy should be tested early with the more highly sensitive tests such as P24 antigen testing and/or PCR-DNA/RNA HIV testing, as an epidemiological management of this disease.

I hope someday, the public can have a real discussion and proper, respectable COMMUNICATION among EXPERTS who are willing to SHARE THE SPECIFICS of their research to show WHY EARLY ANTIGENIC TESTING and/or PCR-DNA/RNA HIV TESTING (done usually to assess viral load) is necessary in HIV/AIDS in a screened HIV-NEGATIVE, LOW-RISK PATIENT-POPULATION, given the fact that apparently it does not influence the ultimate outcome of the disease. I would welcome the opportunity to broadcast this on my online network,CLICK HERE

I WELCOME comments through email correspondence to address this issue.

 

MDC-Atlanta remains committed to keeping patients informed for better quality and safe medical care.