Spectacular progress made in AIDS treatment
DEAR DRS. DONOHUE AND ROACH: I read your column every day, but I haven't seen anything about HIV. Please tell me what the life expectancy of an infected person is. Is there any hope for someone if the medicines he or she is on stop working? Are there new medicines out there? -- Anon.
ANSWER: We have to get a few terms defined so that everyone understands. The virus that causes AIDS is the HIV virus, human immunodeficiency virus. AIDS, the acquired immune deficiency syndrome, is the illness that occurs when the infected person's immune system no longer functions or functions poorly. That happens years after the virus has entered the body.
Many HIV-infected people experience an illness shortly after they're infected, a few days to 10 weeks. This illness consists of some of the following: a sore throat, a body rash, fever, muscle and joint pain, headaches, diarrhea and weight loss. Almost all recover from this initial illness without special treatment.
Roughly 10 years after infection, many infected people come down with AIDS, the illness caused by viral damage to the immune system. A number of rare infections and cancers with peculiar names sprout up: toxoplasmosis, cytomegalovirus infection, pneumocystis infection and Kaposi's sarcoma (a cancer). A large number of patients succumb to these illnesses.
All this is ancient history. Now, a 20-year-old diagnosed as having the HIV virus lives for 50 or more years because of the advances made in treatment. Infected people have close to a normal life span. In the early days, treatment of AIDS required taking many pills at varying times, and the rules for taking the medicines were difficult to follow. Today, treatment, in the majority of cases is one pill a day. That pill contains three drugs.
Doctors treat HIV-infected people much sooner than they used to. That, along with more-effective medicines, has turned HIV infection into a treatable illness. New drugs are constantly appearing. If a person has a virus that is resistant to a particular drug, substitute drugs are available, and that person also should live a long life.
DEAR DRS. DONOHUE AND ROACH: Why don't women ever become bald? Why do only men grow facial hair? Why does hair turn gray as people age? -- S.W.
ANSWER: Some women do become bald. Most, however, have only a thinning of their hair. The reason is that women make much less testosterone (male hormone) than men. Testosterone coupled with inherited genes makes men more likely to lose all their hair. Testosterone promotes facial-hair growth in men. Hair turns gray with age because the production of pigment that colors hair wanes. If only a partial loss of pigment takes place, the hair is gray. A total loss of pigment turns hair white.
TO READERS: The booklet on vaginal infections explains why they happen and what can be done for them. Readers can order a copy by writing: Dr. Donohue -- No. 1203, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order for $4.75 U.S./$6 Can. with the recipient's printed name and address.
DEAR DRS. DONOHUE AND ROACH: I am a man in my early 70s. Five years ago I had an X-ray of my breast because my nipples were tender to the touch. Nothing was found. In the past few weeks, I have had a recurrence of tender nipples. I know men get breast cancer. Should I have another X-ray? -- R.C.
ANSWER: The most common cause for tender nipples is chafing from clothes. Nipple tenderness isn't a standard sign of breast cancer. Outright pain, nipples with an open sore, nipple discharge and nipple retraction into the breast are some signs of male breast cancer. The most important sign is a breast lump.
To play it safe, do see your doctor. The doctor will decide if you need a mammogram. I don't think you will.
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Drs. Donohue and Roach regret that they are unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may write the doctors or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475 or email ToYourGoodHealth@med.cornell.edu with medical questions. Readers also may order health newsletters from www.rbmamall.com.
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