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    HIV Death Gap Closing

    Near-Normal Life Span With Early HIV Detection, Treatment


    That's true, says Margaret Fischl, MD, director and principal investigator of the AIDS Clinical Research Unit at the University of Miami. Fischl has treated people with AIDS since the earliest years of the epidemic. She led the first clinical trial to show that an anti-HIV drug, AZT, could slow what was then the relentless progression of HIV disease to AIDS and death.

    "We know that antiretroviral therapy is effective and can reverse the damage this virus does. And therefore AIDS per se does not occur," Fischl tells WebMD. "Are we beginning to see HIV-related, non-AIDS events? Are we seeing more heart attacks in treated patients? Is it HIV related? Are people getting other malignancies and cancers instead of those traditionally linked to AIDS? Those questions are being asked right now."

    Porter is quick to point out that the treatment success she and her colleagues document does not apply to most people -- even those with access to treatment.

    "This survival isn't what everybody would be getting. But this is what is possible when you diagnose infection early on and get medical care right from the beginning and manage it in an optimal way and treatment gets started when indicated," she says. "Early diagnosis is the most important factor."

    More than 33 million people are infected with HIV. Even by conservative estimates, some 10 million of them need treatment right away -- and only 3 million are getting it. While that's 7.5 times more people than got treatment just four years ago, there's still a very long way to go before even half of the treatment need is met.

    The numbers quickly get depressing. But Fischl remains optimistic.

    "Cure is still a realistic goal," she insists. "Research is looking at ways of enhancing the success of long-term treatment, and even going for the cure. Because we are still asking that question."

    Porter and colleagues report their findings in the July 2 issue of TheJournal of the American Medical Association.

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