The Guide to Living with HIV Infection Developed At the Johns Hopkins AIDS Clinic

Winner of the 1992 American Medical Writers' Association Book Award

When the third edition of The Guide to Living with HIV was published in 1996, the best hope for people with HIV infection or AIDS was treatment with drugs like AZT, to which HIV soon became resistant. In just three years, however, dramatic new treatments have emerged which all but eliminate HIV in the bloodstream. "In my twenty-five years of medical practice," writes Dr. John Bartlett with cautious optimism, "no other breakthrough has translated so quickly to palpable health."

In this fourth edition, Dr. Bartlett, director of the Infectious Diseases Division at the Johns Hopkins Hospital, and science writer Ann Finkbeiner update their widely acclaimed guide in light of developments that have transformed the way we think about treating HIV and AIDS. They describe the breakthrough in understanding how HIV reproduces which pointed to new strategies to track the infection and suppress the virus. They explain the importance of the "viral load" test to measure the amount of HIV in the blood and more accurately gauge a person's response to treatments. And they discuss the remarkable results of using new AZT-class drugs in combination with newly developed protease inhibitors and non-nucleoside reverse transcriptase inhibitors. The combination of these three classes of drugs virtually stops HIV, drastically reducing the virus's numbers and ability to become resistant, while allowing immune cells to rebound.

The authors emphasize the importance of receiving this good news cautiously, since no one knows what the long-term health consequences of taking these powerful drugs might be, or whether the virus will once again develop resistance. Treatment, they explain, is far from easy: most people require at least three different kinds of pills (or "triple therapy"), for a total of up to 20 pills a day. The side effects are difficult, treatment costs between $10,000 and $12,000 a year, and new stresses accompany the uncertainty about long-term effectiveness. Despite the need for caution, the fourth edition of The Guide to Living with HIV Infection explains how to help ensure the effectiveness of the new treatments and, for those for whom the treatments don't work, how to remain well as long as possible. The book remains the most complete resource of its kind for people with HIV and AIDS and for their families and friends.

New to this edition:

* Detailed discussions of new drugs and how they must be administered in order to be effective

* Updated information on the transmission of HIV

* Information about new tests for HIV, including home kits and tests using saliva and urine

* Discussion of the importance of tracking "viral load" and CD4 cell count

* New tables, showing prognosis according to CD4 count, and drugs used to treat or prevent wasting

* New information on opportunistic infections

* Advice on how to live with uncertainty

* New guidelines for choosing physicians

* Updated resources, including addresses for websites

John G. Bartlett, M.D., is professor of medicine at the Johns Hopkins University School of Medicine and director of the Infectious Diseases Division at the Johns Hopkins Hospital. Ann K. Finkbeiner is a science writer and teaches at the Johns Hopkins University's Writing Seminars. She is the author of After the Death of a Child, also available from Johns Hopkins.