The Guide to Living with HIV Infection: Developed at the Johns Hopkins AIDS Clinic (A Johns Hopkins Press Health Book)

When the fourth edition of The Guide to Living with HIV Infection was published in 1998, the effects of the new drugs against HIV were only beginning to be appreciated. Since that time, rates of hospitalization, serious illness, and death have dropped by 60 to 80 percent and have stayed down. Several years ago, one young woman with no remaining immune system had made the decision, despite her odds, to be kept alive artificially; she now lives a healthy life, has a near-normal immune system, and, for the last three years, has had no detectable HIV. Her world, and the world for most people affected by HIV infection, is radically changed.

In this new edition of their acclaimed guide, Dr. John Bartlett, director of the Infectious Diseases Division at the Johns Hopkins Hospital, and science writer Ann Finkbeiner thoroughly update their discussion of the disease, from the evolving issue of when to start treatment to the new and sophisticated tests for the response to treatment, for the state of the immune system, and for HIV's resistance to various drugs. They describe these drugs' unanticipated side effects, among which are changes in peoples' appearances and increases in the lipid levels of their blood. They offer advice on adhering to the drugs' regimen–a regimen so strict and demanding that even AIDS doctors, in trials using placebos, failed it. And they explain the medical strategies by which the levels of HIV can be pushed down to an undetectable level and made to stay there.

The authors emphasize the importance of receiving this good news cautiously. Though improvements in the drugs have made them easier to take, they still cost between $10,000 and $12,000 per year, and no one knows whether HIV will develop resistance to them. New stresses accompany this uncertainty, and new perspectives accompany this new world. This latest Guide to Living with HIV Infection offers valuable advice both to those for whom treatment works and to those for whom it doesn't–all focused on remaining well as long as possible. The book continues to be the most complete source of medical, emotional, social, financial, and legal advice for people with HIV infection and for their families and friends.

New to this edition: • Using the CD4 cell count and viral load tests to monitor response to treatment, to assess prognosis, and to indicate the state of the immune system • New tests of HIV's resistance to the various drugs against HIV

• Advice on when to start treatment

• Strategy for achieving "no detectable virus"

• Tricks for adhering to the strict regimen required by the anti-HIV drugs

• New information on the unanticipated side effects of the anti-HIV drugs

• Advice to women with HIV infection who become pregnant • New information on the risks of transmitting HIV

• Changes in emotional perspective resulting from living with HIV infection

• New guidelines for choosing a physician

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 who teaches in the Johns Hopkins University's Writing Seminars.