By AIDS Services of Austin

AUGUST 3, 1998:  George, who is HIV-positive, began the new HIV medications two years ago. They have dramatically reduced his HIV level and improved his T4-cell count. Previously bedridden, he now feels better and is even contemplating part-time work. But recently he has developed diabetes, a disease unknown in his family, and his abdomen is swollen with fat, even though he's losing weight in the face and neck. However, it's the 700% rise in cholesterol that worries him, because heart disease is no family stranger.

The new combination therapies introduced since 1996 have made a remarkable difference. But all may not be well in the long-term therapy picture. Medical professionals are noticing abnormally high levels of triglycerides and cholesterol among HIV+ clients taking antiviral medications.

The cause is not clear, but protease inhibitors, a powerful component of the "drug cocktail," are suggested as a prime suspect. Other possibilities are the HIV infection itself, other anti-HIV drugs, or the higher fat diets required with the new antiviral therapies.

Increased lipid (fat) levels, including cholesterol and triglycerides, may lead in time to coronary artery disease, heart disease, or stroke. Diabetes and hyperglycemia is also rising abnormally among HIV+ people.

Information presented at the Geneva conference speculates that immune restoration, even viral elimination, may be possible if the medications can be maintained for seven to 10 years. Questions are being raised, though, as to whether this long-term maintenance is possible, and if so, what other negative health developments time may hold.

For those who think HIV/AIDS isn't any big deal anymore (and their behavior choices aren't important): Wake up! Treatment is better than it was, but this is still a nasty disease to have.

Sandy Welles, RN
Sandy Bartlett, Community Information/Education Coordinator
AIDS Services of Austin