You keep writing about AZT. How often is AZT used anymore? AZT is a drug with terrible side effects, but it was the only thing that had any promise at the time. Since AZT isn't widely used anymore, what do you have to say about the newer classes of drugs? Are they immunosuppressants too that are killing people?
Bbucko could explain the use of AZT and other AIDS drugs far better than I can, but with my limited knowledge, I don't think the newer drugs have the same problems that AZT does.
AZT was introduced in 1988 and was the first therapeutic medication for those living with HIV/AIDS. By the early 90s, drugs like DDI and D4T came on line. They were rarely mixed in the "cocktail" that became popular with the introduction of Protease Inhibitors in 1996. It was called "monotherapy" and very quickly went out of favor.
The earliest patients on monotherapy AZT were real-life guinea pigs. The dosing was at levels that no one would prescribe today, and it was exceedingly toxic. It's for that reason that very few survivors of monotherapy are still around to tell their tales (but they do exist).
But AZT is still widely prescribed today, mixed with other medications and delivered in much smaller, more exacting doses. A combination of AZT and 3TC was among the very first treatments I received back when I was first diagnosed. DDI was also one of the subsequent medications I took for almost three years.
They were and are all dreadful, even in smaller doses, and have left me with peripheral neuropathy (mild) in my ankles. 3TC and another medication called Zerit are also responsible for most of the fat wasting in my face, giving me a new, thinner face in my mid-40s. I have included two face pix in my gallery which show this wasting. To the casual observer or someone who doesn't know what my face used to look like, nothing seems obvious or out of whack. But to anyone familiar with this side effect from the meds, it's obvious.
I was also on a double Protease Inhibitor called Kaletra, which caused my body to metabolize fats differently and caused my cholesterol to go from 150 to 575 in about three weeks. I joke that my triglycerides were on the level of a goose being prepared for foie gras, but there was enough urgency to have me admitted to the hospital for observation on Christmas Eve 2001.
I was instructed to maintain a strict no-fat, no-cholesterol diet with no exceptions (ever) along with two different Statins, each with their own restrictions and side-effects. Within six months I was out of dangerous territory, and within 18 months my cholesterol returned to under 200.
Another of Kaletra's side-effects is constant lower GI disturbance. I could never be more than ten minutes from a toilet. The combined daily "garden hose" diarrhea and extreme diet effected a net loss of 35 lbs and whatever I ever had of a butt. My waist went from a normal, healthy 32" (OK, 33") to 28", which I had as a teenager but not since.
I am going into such nauseating detail because all these issues (and others I'll save for a rainy day) were considered "acceptable" side-effects by my doctors. I have never been taken off a medication because of toxic side-effects in over ten years of taking them. The only time the choice has been made to discard a medication was when I experienced viral "breakthrough" ie: lack of suppression. This has happened frequently.
Among the more recent medications is Ziagen, which is either given by itself or in conjunction with 3TC in a concoction called Epzicom (which sounds like a wireless phone service). For upwards of 5% of the population Ziagen (Abacavir) is a deadly poison that kills within 24 hours, and every prescription comes with warning cards. It's pretty vile stuff, but hasn't killed me.
Sustiva, which I've never taken, is one of the very few medications that can cross the blood-brain barrier (AZT is another) and is therefore thought to combat HIV in nerve tissue where it is known to thrive and is otherwise unreachable by medications. But Sustiva causes side-effects ranging from nightmares to psychotic episodes.
There are many people who take a few pills (or even one) everyday and never have side-effects. They are the ones that you see in all those pharmaceutical ads showing people climbing mountains and lifting weights. What you never see are those who have grown humps on their backs, or with huge bellies and spindly legs, or those with such bad facial wasting (lipoatrophy) that they just have veins, bone and skin left on their heads.
These "walking wounded" might well have 1200 T-Cells and undetectable viral loads, but live with damaged livers, chronic pain and permanent disfigurement.
They are the true survivors. There are hundreds of people dying every year still because the meds are too toxic or ineffective for them.
There are also American citizens placed on waiting lists because the demand for the meds is greater than the funds to pay for them. Federal Ryan White and ADAP funds are administered by the states, not all of which do a great job.
Even if your state has the funding to pay for your treatment medications, there are income eligibility restrictions, usually about $30,000 per year. Earn more than that and you loose your meds and your doctor. This keeps folks living with HIV and working at jobs without health insurance poor.
The medications that keep us alive have some pretty astounding side-effects, all things taken into account.
