In the eighties and the nineties, it was frequent that viruses that cause AIDS and hepatitis C affected patients at the same time, since both of them are intravenously transmitted as people share syringes when injecting drugs. Some years ago patients died of AIDS prematurely; nowadays, with the new treatments, survival is improving and there is enough time for hepatitis C, which has a protracted course, to progress to advanced forms hat may be the cause for the death of many coinfected patients.
According to the UGR specialists, the health and scientific system has a great challenge that will be solved in the following years, when the medicines that are being developed cure a higher percentage of chronich hepatitis C than the nowadays available ones.
Effective treatments
However, great progress has been made in relation to the HIV. There are very effective treatments that prolong and improve the quality of life of the patients infected with HIV since 1996. In this sense, “practically no patient under treatment die with AIDS”, Doctor José Hernández Quero, Professor of Internal Medicine of the University of Granada, points out. In the opinion of Doctor Juan Pasquau, from the Virgen de las Nieves Hospital, “I do not consider a patient with HIV who comes to my consulting room to be more likelihood of dying in the short term than a smoker”.
The problem is when the HIV has not been detected. “Official sources keep living slanted information, since they only count the AIDS cases, without taking into account the infected with HIV, who probably will not develope the disease”, Hernández Quero adds. Indeed, the National Plan against AIDS declares the sick persons, but not the infected with the virus.
Results are hopeful in Spain. According to official data, in the first period of six months of this year 11% less AIDS cases have been diagnosed than last year. Numbers confirm the trend of previous years. The so-called “risk groups”, such as homosexuals and heroin addicts, become less infected while heterosexual transmission is increasing.
Side Effects
Dealing with drugs side effects is another big challenge for AIDS patients. Uninterrupted medical treatments prolong life, what causes other problems in many cases. Processes like arteriosclerosis and diabetes speed up. The so-called lipodystrophy appears too. The disease consists of an anomalous distribution of fat in the body; fat gathers at the abdomen and disappears from the face and members. The aim is “to continue the treatment with firm hand and to postpone it by observing the evolution of the inmune system”, Doctor Pasquau explains.
Nowadays there are a dozen of commercialized drugs for HIV patients and there are quite a lot of them under development. Patients are always administered combinations of three of them to suppress virus replication, which is very fast, avoiding this way inmune deterioration, one of the keys to the disease, and the selection of viruses with resistance mutations to these drugs. This way, therapeutic possibilities are limited.
The study of genomic resistance is very important, as it allows to avoid drugs to which the virus is resistant; Granada is a pioneer in this kind of studies, specifically the Microbiology Service of the Unit for Infectious Diseases of the Teaching Hospital. Thanks, among others, to Doctor Federico García´s work, these analyses allow to know beforehand the resistance to certain antiretroviral agents, avoiding those which are not going to be effective land limiting toxic effects.
Hernández Quero, director of this Unit of the Teaching Hospital, points out that “the sociological spectrum of the infected patients has changed. They are usually between 30 and 40 years old, and younger if we talk about sexual transmission. As for the difference by sex, there are more men in Granada: between 65 and 70% of the infected”. The doctor is also proud that “most of the infected in the eighties, when we started working in the Unit, still follow the same treatment we provided them. We have aged together”.
Further information:
Prof. José Hernández Quero.
Department of Medicine.
University of Granada.
Phone number: 958 24 90 79.
E-mail: jhquero@ugr.es
