was possible. They are living longer.

Back in the "early days'', people with AIDS succumbed very quickly and died.

This was because AIDS was a new disease and not much was known about it.

The medical profession was limited in their knowledge and treatment. The prognosis at that time was grim. AIDS was a fatal disease and persons who were diagnosed, died anywhere from six to eighteen months later.

In 1987, a new drug was approved by the Food and Drug Administration (FDA).

After extensive research and clinical trials, the medical profession finally had something to offer people with HIV infection -- an antiretroviral drug called AZT or Retrovir.

Antiretrovirals are used to treat persons with HIV infection, just as antibiotics are used to treat bacterial infections. Research proved that patients receiving this drug showed an increase in the specific white cells, known as T4 cells, that are responsible for resisting infections. These patients also gained weight, felt better and were living longer. This was the first intervention that seem to be effective.

How does AZT work? It inhibits replication of the human immunodeficiency virus (HIV) inside the T4 cells. It does this by imitating one of the materials HIV uses to replicate. The virus somehow incorporates the AZT into the chain, but is unable to complete the process of infecting a new cell. This means that more of the T4 cells escape infection, thereby preserving a person's current level of immunity.

AZT is available to anyone with HIV infection and AIDS. Since the cost of AZT for one person is very expensive (approximately $2000 a year), it is provided free of charge, paid for by the Health Department. It is prescribed by a consultant physician, who will examine the patient as well as their blood tests results. Authorisation for dispensation of AZT is by the Chief Medical Officer.

Once a person commences AZT therapy, they must have regular blood tests done every four to six weeks. These tests are to observe the level of the white and red blood cells, as one of the side effects of AZT is anaemia (loss of red cells). Other side effects are nausea, headaches and loss of appetite.

However, the benefits of taking AZT far outweigh the side effects.

Another drug called DDi or Videx was FDA approved in 1991. This is also an antiretroviral and is used to treat adult and paediatric patients (over the age of six months), with advanced HIV infection who are unable to tolerate AZT therapy or have shown significant deterioration during AZT therapy. Some of the side effects of DDi are inflammation of the pancreas, diarrhoea and peripheral neuropathy. At present DDi is not available in Bermuda, but arrangements are being made by the Health Department.

There are other such drugs like Kemeron and DDc, but they are not FDA approved. According to a survey done in 1991, there are a total of seven vaccines in clinical testing.

Although the fight against AIDS must seem agonisingly slow to those living with HIV and their loved ones, there are encouraging signs of progress, such as the increased number of drugs used to treat the various infections.

For further information, please contact your physician or the Department of Health.

Rhonda Daniels Nurse Epidemiologist Department of Health.