This morning actor Charlie Sheen revealed that he is infected with human immunodeficiency virus; i.e., he is HIV+. Sheen’s public disclosure of his diagnosis serves as an important reminder for those who may not remember the time before HIV and the disease it causes, acquired immune deficiency syndrome (AIDS), were able to be controlled.
Charlie Sheen visits the Today Show [Image: Today]
The reminder is that this disease still exists, and despite the ability of clinicians to control it under ideal circumstances, it is still a major threat to the health and well-being of many. The mantra that we routinely chant now in medicine is “AIDS is not a death sentence.” It is not; however, that does not mean its treatment and management are as simple as taking a daily pill. A perhaps misplaced sense of complacency has emerged, and Mr. Sheen’s disclosure of his diagnosis serves as a opportunity to address it. We would do well to advise those who either have forgotten the AIDS epidemic or are too young to have witnessed it that this is not simply a condition that requires a pill every day. To that end, here are 7 reasons why an HIV+ diagnosis in the United States matters:
HIV/AIDS has not been “cured”; medical science has simply developed medications to control the infection.
Antiretroviral (ARV) drugs must be carefully timed. Depending on the drug combination, this can require taking numerous pills multiple times per day. It can be as “easy” as taking a single pill as few as three times per day, but often it is more complex.
ARVs have a wide variety of side effects, ranging from nausea and diarrhea to peripheral neuropathies resulting in either chronic pain or loss of sensation
ARVs are expensive. The out-of-pocket costs for appropriate therapies can be financially devastating
HIV+ individuals hoping to conceive children are advised to seek fertility assistance to assure that an uninfected partner does not become infected while trying to conceive. For HIV+ women, ARVs must be taken throughout pregnancy. Both of these interventions are very costly.
There are increasing reports of ARV drug resistance. While triple drug cocktails make the emergence of resistant viruses a rare event, these events do indeed happen. If you are infected by a drug resistant strain, being HIV+ resumes being very difficult to treat, if not a death sentence once again.
Recent years have illuminated the effects of HIV on patients who have been infected long-term. These effects were not observed initially because HIV+ patients used to develop AIDS and die before they could develop. HIV-associated neuropathies in particular have been noted, and result in chronic pain and dementia.
While those who are newly diagnosed with HIV have many more reasons for hope than they would have twenty years ago, it is important that we note that this virus is not trivial. We can control it, but we cannot eliminate it. HIV is not something to be trifled with. It has one of the highest mortality rates of any virus known to humanity, second only to rabies. Think about that. Left untreated, you have a far better chance of surviving Ebola infection than you do HIV infection. We have become complacent. Let Mr. Sheen’s revelation serve as a reminder that we should not be.
Remember these days? [Image: Time Magazine]