Today there are treatments with minimal side effects and even HIV prevention therapies.
Dr. Lizette Santiago Colón, family medicine and Medical Director HOPE Clinical Research and Dr. Roberto Calderón, specialist in Internal Medicine and HIV. Photo: Medicine and Public Health Magazine.
In dialogue with the Journal of Medicine and Public Healththe Dra. Lizette Santiago Colón, family medicine / AAHIVS y Medical Director HOPE Clinical Research highlighted the evolution of the diagnosis and treatment of HIV in Puerto Ricoachieving that at present, there are multiple medications to treat it, which have allowed patients have a better quality of life and not be hindered by disease.
“Initially, the THAT it was the first medicine for HIV in 1987, it was very toxic and used many times a day, so very few patients could tolerate it, especially since at that time most people were diagnosed when they had AIDS, that is, the immunological condition very advanced”.
Later, over the years, other medications began to be added for the treatment of patients, it was what was known as the ‘HIV cocktail’, which “included a combination of treatments that included between 14 and 24 tablets, up to five times a day,” added Colón. Furthermore, the patients were affected not only by the frequency but also by the toxicity they causedlimiting them to his life everyday.
In this regard, the specialist highlights that “today most of our patients take only 1 tablet a day that combines many of these medicationseven now we can delve deeper into therapies that are being done, such as injections every two times, without medication.
For his part, the Dr. Robert Calderonspecialist in Internal Medicine and in HIVacknowledged that being able to reduce the amount of medication that patients needed helped them maintain the virus undetectable, in addition to the great medical advance led by Puerto Rican specialists, HIV in pregnancy: “today we can offer the security that a woman can get pregnant living with HIV and having the certainty that the baby will be born without HIV” .
“Our reward is when we see in the laboratories, blood samples from how the virus is behaving and we see that it is undetectableexpressed the Dr. Colon“the great reward to know is that if I eat patient I am undetectable, I do not transmit my virus to another person, that is, it is non-transmissible and that allows the patient to enjoy his life and therefore improves their quality of life,” he added.
Specialists point out that the life expectancy of a person with HIV is the same to that of a person who does not have the condition, so scientific advances and treatments are of the highest quality. Nevertheless, the methods of exposure remain the same since the detection of the first case of HIVso they emphasize the importance of getting tested, since all people are at risk of becoming infected.
In this regard, Dr. Colón acknowledges that “in the 1980s and 1990s, the highest incidence in Puerto Rico was the population that used injectable substances, that was the main method of transmission, but today, the population older than we have we are men from the LGBTQI community, since having sexual activity exposes them to greater risk”.
On the other hand, it indicates that women have always been in a second level in relation to statistics, since women in stages of pregnancy undergo these routine tests, then it can be detected, but in men it depends on what identify it and come to take the test.
HIV and its evolution against other viruses
For Dr. Calderón, if what is known about COVID is compared in terms of years, he could say that it is a virtually new viral disease, however, it has made progress in a short time. “If we review history since HIV began in the 1980s and everything we have in 2022, we can say that studying, understanding, knowing and controlling the virus has not been an easy task, but we have to take into consideration that we did not have the technology that we have today that allows us to study the behavior of these viruses quickly.
Another virus to which he referred is the HPV, which is very common in patients. “There is no treatment for HPV to date and we have known about the virus for years, in addition to the health problems it causes, but there is currently no treatment.
He also highlighted that HIV, being an inflammatory disease, also causes patients to develop complications earlier, such as cancer, and the development of metabolic diseases such as diabetes, high blood pressure, kidney and cardiovascular system problems and that directly impacts public health.
In this sense, the specialists point out that one of the biggest challenges when they receive a diagnosis of a patient with HIV is not the treatment because they affirm that there are good medicines with few side effects, but rather the fact of empowering the patient who comes full of fear, with fears and crises about their situation of having been infected.
For Dr. Colón, the impact of the evolution of HIV could have been mitigated decades ago, since she considers that the time when the spread began was wasted, because HIV affected the LGBTQI population, which for the context of 80’s years, they were a marginalized community and the scientific medical approach was not oriented to the needs of that population.
Also, he stated that the behavior of the virus is complex, the ideal would be to have a vaccine, however, it has not been possible because the virus mutates.
HIV prevention
“I remember the first time I talked about prevention for HIV and the doctors looked at me strangely, since they did not explain how we are going to give medicines to patients who are well,” said Dr. Colón, who in turn affirms that today HIV prevention is an initiative that is being carried out in Puerto Rico. “We even have in the Ararat Center a sexual health clinic where prevention treatments are offered and the idea is that if I have a risk exposure, it is identified in interviews and tests to start treatment,” he added.
Likewise, the specialist emphasizes that they have helped many patients, since not everyone is going to be in prevention forever, but the fact that the patient takes a medication helps him modify the behavior of the virus so as not to take risks.
HIV in older adults
In relation to infection in adults, Dr. Calderón states that statistically patients with HIV in Puerto Rico and the US, are between the ages of 24 and 50, in the productive agehowever, there is an older adult population that is becoming infected and they are more vulnerable, so their life expectancy decreases.” What we have to take into consideration is to guide this population and order all the studies to be able to know if they are developing or not some type of serious complications”.
The future of HIV and its treatments
For specialists, in the next 5 to 10 years, the evolution of HIV treatments will be positive, since drugs are being developed by subcutaneous means or implants under the skin, with a duration of 6 months to a year, in which patients will be able to control the disease and have a better quality of life.
Regarding the symptoms of HIV, it is important to know that when they begin to manifest, it is when the patient’s immune system is low and many of the symptoms are associated with an opportunistic diseasefor which they reaffirm the importance of the tests, because the symptomatology arrives very late.
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