Читать книгу Knowing One's Medical Fate in Advance - Группа авторов - Страница 10

When a patient achieved severe immune deficiency, i.e. a CD4-T cell level below 200 cells/µl, survival was rare beyond two year as there were no good treatment options available.

A landmark study published in 1997 showed that by measuring HIV viral load and CD4-T cells the probability to have AIDS, i.e. the disease, within 3 years could be predicted [1]. For example, a patient with high viral load above 100’000 copies/mL and low CD4-T cell counts had a very severe prognosis as stated above. One has to keep in mind that this was only 13 years ago and that today such a patient with treatment has a completely different prognosis.

What happened between 1996 and today was unexpected and unprecedent - the progress of HIV treatment was fabulous. In the late eighties HIV drugs were not effective beyond six months of therapy. From 1996 on several new HIV drugs were used in combination, showing a dramatic reduction in morbidity and mortality [2]. Briefly, the mechanism for treatment works via stopping the replication cycle of HIV at very different stages of the virus/cell cycle. In particular, drugs stopping the activity of the HIV reverse transcriptase and protease are most effective and inhibit the virus copy machine with a frequency of 10 billion times a day very efficiently.