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HIV study indicates potential resurgence of AIDS cases

By Suzanne Sprague, KERA 90.1 reporter

Dallas, TX – Suzanne Sprague, Reporter: HIV antiretroviral therapy, commonly known as the HAART drug cocktail, was introduced in 1996. Almost immediately, the number of AIDS-related deaths declined. But according to recent research published by Dr. Mamta Jain, an HIV researcher at U-T Southwestern Medical Center, those who are dying today from AIDS may be dying needlessly.

Dr. Mamta Jain, U-T Southwestern Medical Center, Assistant Instructor: 50% of our patients were not taking HIV therapy and so they were dying from the same diseases they died from in the pre-HAART era. And it really made you think, these are patients whose deaths you wonder if they could have been preventable.

Sprague: Dr. Jain's particularly concerned because two-thirds of the patients in her study at Parkland Hospital who were not on HAART when they died were ethnic minorities.

Dr. Jain: So it makes you wonder if access to care, if immigration issues, if all of those factors, may not have been a barrier to them coming in.

Sprague: Women, Hispanics and African-Americans are among Parkland's fastest growing groups of HIV-positive patients. But Dr. Philip Kaiser, Parkland's director of HIV and AIDS Services, says there's been little advocacy and education in those communities. So now, the hospital is targeting its outreach efforts there.

Dr. Philip Kaiser, Parkland Hospital, Director of HIV and AIDS Services: The sorts of things we're trying to do is place clinics in communities where they have high rates of HIV, clinics in communities of color. We're actually working with the Urban League to establish a clinic in southern Dallas.

Sprague: And in order to entice more women to seek treatment, Parkland has set aside one day each month at its HIV clinic for female patients only. But Dr. Kaiser says the drugs themselves may pose a more fundamental challenge to fighting AIDS.

Dr. Kaiser: What we're asking them to do is take a lot of medicine that's going to make them feel bad and then it will not only make them feel bad, it may actually change the way they look, and many people just don't want to do it.

Sprague: For Sue Gibson, who's been HIV-positive since 1989, the side effects from the HAART drugs have included joint pain, chronic diarrhea and a condition called lipodystrophy, which has redistributed her body fat to her abdomen.

Sue Gibson, HIV Patient: The side effects are very disturbing. I look like I'm about 8 months pregnant and that's embarrassing.

Sprague: Gibson took a so-called drug vacation last summer to alleviate the side effects, but she quickly became very sick and returned to the HAART cocktail. So she's sympathetic to other HIV patients who want to give up the drugs and take their chances with the disease.

Gibson: I do understand. I understand that decision very easily.

Sprague: But taking the HAART cocktail may reduce the spread of AIDS from those patients who are sexually active. So if large numbers of people who need the drugs can't or won't take them, some doctors fear the number of AIDS cases may rise to pre-HAART era levels. That could reverse the decline in AIDS-related deaths that followed the introduction of HAART. Dallas County has seen a 20 % jump in the number of confirmed AIDS cases since 1999. Short of a vaccine, doctors say their best bet for containing the disease is getting HIV-therapy to more patients and finding ways to make the drugs more tolerable. For KERA 90.1, I'm Suzanne Sprague.

Email Suzanne Sprague about this story.