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- <text id=89TT1568>
- <link 93HT0772>
- <link 93HT0535>
- <link 89TT1767>
- <title>
- June 19, 1989: Longer Life For AIDS Patients
- </title>
- <history>
- TIME--The Weekly Newsmagazine--1989
- June 19, 1989 Revolt Against Communism
- </history>
- <article>
- <source>Time Magazine</source>
- <hdr>
- MEDICINE, Page 52
- Longer Life for AIDS Patients
- </hdr><body>
- <p>New drugs are giving hope but also raising difficult questions
- </p>
- <p>By Dick Thompson/Montreal
- </p>
- <p> A new generation of AIDS patients may be on its way. It is
- a generation of hope -- not for a cure anytime soon but for a
- longer and more productive life despite the disease. One of its
- heralds is a 30-year-old housewife named Belinda Mason, who was
- infected with the virus when she received a transfusion of
- untested blood during delivery of her second child. She lives
- in Tobinsport, Ind., a heartland town where AIDS services are
- scarce and discrimination against patients is all too common.
- Yet Mason, who is chairwoman of the National Association of
- People with AIDS, is convinced she is witnessing the
- transformation of the epidemic. Says she: "I think I'm going to
- be in the first generation to see AIDS become a chronic,
- manageable illness."
- </p>
- <p> Last week, as 11,000 physicians, scientists and health
- officials gathered in Montreal for the fifth International
- Conference on AIDS, evidence was building that Mason could be
- right. While AIDS is still cutting lives short, early
- intervention with new drugs is lengthening the time between
- diagnosis and death and offering the hope that a full life for
- the disease's victims may some day be possible. Said New York
- City Health Commissioner Stephen Joseph in Montreal: "We are
- very close to turning the corner on this epidemic." But there
- is a price tag to this success. Medical b-ills for the growing
- pool of infected people will be staggering. And a surprising
- number of AIDS-virus carriers are returning to high-risk
- behavior that could spread the infection to others.
- </p>
- <p> The gloom of AIDS is being eased somewhat by two drugs, AZT
- and pentamidine. In 1982 less than 30% of gay men diagnosed with
- AIDS in New York City lived more than 18 months. By 1987, after
- the introduction of AZT, survival at 18 months jumped to 62.9%.
- Says Michael Callen, a singer and songwriter who has had the
- disease for seven years: "We need to change our conception of
- AIDS. Not everyone dies of AIDS." Today about 70% of all AIDS
- deaths result from Pneumocystis carinii pneumonia. But studies
- reported in Montreal confirm that pentamidine inhaled directly
- into the lungs is dramatically effective in preventing the
- pneumonia from developing. Federal health officials are so
- impressed by the drug that they will recommend that those
- infected with the virus start monthly aerosol treatments as soon
- as their immune systems begin to weaken.
- </p>
- <p> Like all AIDS care, other drugs showing promise in the lab
- will be expensive. At typical dosages, AZT costs each patient
- about $7,000 a year, and pentamidine up to $1,200. Since more
- than 1 million people in the U.S. are believed to be infected
- with the virus, the national AIDS medical bill is expected to
- soar to between $4.5 billion and $8.5 billion a year by 1991.
- Moreover, the demand for outpatient services, nursing homes and
- housing for AIDS patients is expected to overwhelm health care
- systems in the hardest-hit cities.
- </p>
- <p> For researchers the most urgent need may be to regain
- control of studies being conducted to test the efficacy of
- various AIDS drugs. Now that doctors have medications that work,
- they need to find what works best. But for the past several
- years, experimental drugs have first been available on the AIDS
- black market, through which patients who felt they had little
- to lose began their own treatment programs. The FDA, responding
- to intense public pressure to demonstrate both compassion and
- efficiency, has established a "fast track" for the approval of
- AIDS drugs. However, that streamlining may have permanently
- distorted the traditional protections afforded by careful drug
- studies. Some scientists are demanding a stop to
- self-experimentation.
- </p>
- <p> Despite all the progress, the AIDS virus still takes a
- terrible physical and emotional toll. Each day at New York
- City's Montefiore Medical Center, women infected with the AIDS
- virus ask if they can still have children. Patients are told
- that chances are greater than 1 in 4 that their child would be
- born with the virus. The prognosis for these children is bleak,
- especially since they may be orphaned.
- </p>
- <p> As people infected with the AIDS virus live longer, some
- are drawn back to high-risk behaviors such as unprotected sex
- or needle sharing, which exposed them to the virus in the first
- place. Investigators in New York City have found that nearly a
- third of the intravenous drug users who stopped sharing needles
- because of the AIDS scare later started again. A study of gay
- men in Chicago has shown that a quarter of those who had begun
- to practice safe sex occasionally reverted to unprotected sex.
- Officials in San Francisco are concerned that these behavioral
- relapses may soon trigger another increase in new infections.
- </p>
- <p> The new drugs are extending lives, but it is uncertain
- whether they are adding decades of productive life or merely
- postponing by a few years the eventual calamity of early death.
- And many of the lives being lengthened are either dangerous to
- others or sexually isolated and childless. Says a 27-year-old
- military officer infected with the virus three years ago:
- "Meeting someone to marry is going to be very difficult. And
- being celibate is not easy for anyone." Still, says Belinda
- Mason, "every day is a gift." </p>
-
- </body></article>
- </text>
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