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What Is the Most Pressing Issue in HIV Care Today?

July 23, 2013


Joseph Gathe, M.D.

Morbidity and Mortality Rates

"I think the most pressing issue is the need to decrease the morbidity and mortality of HIV-treated patients with CD4 counts above 200. That is what the biggest issue is in my practice now, as far as treatment is concerned.

"I can treat people who have AIDS with effective regimens. I can keep people undetectable when they're on [treatment], but I'm still seeing death rates that I'm not happy with, [despite] good CD4 counts. We have to have some impact on that.

"It goes along with what is going on with the patients and their cardiovascular, liver, kidney -- all these toxicities, some of which is related to drugs, but some of it is because people have had HIV for five, 10, 15, 20 years. The question is: Can we make an impact on those inflammatory pathways that have been associated with all these toxicities? Do we have markers to find these inflammatory pathways that may be a benefit to the long-term survival of HIV patients?"

-- Joseph Gathe, M.D., Private Practice, Houston, Texas

This article was provided by It is a part of the publication The 20th Conference on Retroviruses and Opportunistic Infections (CROI 2013).

Reader Comments:

Comment by: John Marshall (Essex, Mass) Sat., Oct. 19, 2013 at 2:17 pm UTC
Thank you doctor, you understand what living with HIV means. Spread the word.
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Comment by: John Marshall (Essex, Mass) Sat., Oct. 19, 2013 at 2:12 pm UTC
Like most doctors, he tries to minimize the side effects of the meds. Severe adverse events stage 3/4 can happen. The number may be as high as 25% of patients. The meds are highly toxic and can be debilitating. The NRTIs cause a lot of irreversible damage to body chemistry. Diarrhea my ass.
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Comment by: bcilla13 (atlanta, ga) Tue., Sep. 10, 2013 at 12:49 pm UTC
treatment is without doudt the key to our survival i encourage everyone suffering from this illness to get into care and remain in care, the only way to sustain life span is by treating this disease aggressively.
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Comment by: todd jackman (Vancouver, bc) Fri., Aug. 2, 2013 at 4:15 pm UTC
is Cambrigde Ontario a good place for an HIV+ individual.Honestly please tell me if they are up to speed?
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