^bc-magic-treatment-ndy - a1801<

^(ndy) (ATTN: National, Sports editors)<

^Questions and Answers About AIDS<

^By B.D. Colen=

^(c) 1991, Newsday=

Basketball superstar Earvin ``Magic'' Johnson's announcement that he is

infected with the human immunodeficiency virus has, like previous milestone

events in the AIDS epidemic, triggered a flood of questions about the disease.

Among them:

^Q:@ Magic Johnson said he is HIV-positive but does not have AIDS.

What's the difference?

^A:@ Acquired immune deficiency syndrome is the end point of a

process that begins when a person is infected with HIV. A person who has AIDS

is fatally ill. A person who is simply HIV-positive is not sick.

^Q:@ How do people know they are HIV-positive?

^A:@ Their blood is tested for antibodies to HIV. If an initial

test, called an ELISA, indicates the presence of antibody _ and thus that the

virus has infected the individual _ a second test, called a Western blot, is

done to confirm the first test results.

^Q:@ Magic Johnson said his wife tested negative for HIV. Does that

mean that she and the fetus she is reportedly carrying are not infected?

^A:@ According to Dr. Jack DeHovitz, director of the AIDS

Prevention Center at New York State University's Health Sciences Center, there

has never been a report of an HIV-infected baby whose father was infected but

whose mother was not. If Johnson's wife is not infected, her baby will not be

infected either, DeHovitz said. Because there is a ``window'' of three to six

months after infection during which a person may be infected but test negative,

experts such as DeHovitz recommend a second HIV test six months after the last

sexual encounter with an infected individual.

^Q:@ In most viral infections, a person gets sick within about 10

days of infection. How long after HIV infection does a person get AIDS?

^A:@ Estimates of the median period from infection to what is called

``full-blown AIDS'' range from seven to 12 years. That means half of those

infected will get AIDS sooner that, and half will take longer.

^Q:@ How does the infection progress?

^A:@ Shortly after HIV infection, most people develop a flu-like

illness they generally ignore, as they are unaware they have been exposed to

HIV and the symptoms quickly disappear with no apparent long-term effect.

About three-quarters of newly infected people also develop a red rash that

covers the body and can last up to a week.

Then, HIV-positive individuals may go several years with no warning sign of

disease, according to Dr. Mark Kaplan, chief of Infectious Disease at North

Shore University Hospital, in Manhasett, N.Y. After that, he said, they may

``experience five or six years of subtle symptoms _ instead of one cold and

sinus attack a year, they may have three or four. Then they may have four or

five or six minor infections.''

This increase in infections is caused by the generally slow collapse of the

immune system, which is attacked by HIV. The virus infects and destroys the

T-helper cells, keys to the body's defense system, and when the number of

helper cells falls below about 500, the infected individual is in trouble.

^Q:@ At what point does the person actually have AIDS?

^A:@ Until recently, a person was said to have AIDS when he or she

tested positive for HIV and developed one or more of a number of so-called

opportunistic infections, including pneumocystis carinii pneumonia,

toxoplasmosis in the brain and Kaposi's sarcoma, a form of skin cancer. Such

conditions pose little risk to people with healthy immune systems. Recently,

however, the federal Centers for Disease Control broadened the definition to

include everyone who is HIV-positive and has a helper T-Cell count below 200.

^Q:@ Once a person has AIDS, how long does he or she live?

^A:@ While there have been isolated cases of individuals with AIDS

surviving as long as 10 years, people with AIDS survive a median of two to two

and a half years, DeHovitz said.

^Q:@ Does everyone with HIV infection eventually get AIDS?

^A:@ Based on current medical evidence, the answer is ``probably.''

But by the time many of those who are now HIV-positive reach the point where

they would be expected to develop full-blown AIDS, there will also probably be

additional therapies to hold the disease at bay.

^Q:@ What can be done to keep an HIV-infected person healthy?

^A:@ Like anyone with a chronic disease, those who are HIV-positive

are advised to get plenty of rest and to eat well. They are also advised to

cook all meats carefully to reduce the possibility of toxoplasmosis infection,

as well as carefully cooking chicken and eggs to avoid salmonella infection,

DeHovitz said.

When carriers' helper T-cell count falls below 500, they are advised to

begin taking the anti-viral drug azidothymidine _ AZT _ said North Shore's

Kaplan. When the count falls below 200, they are generally started on a drug,

such as Bactrim or pentamidine, to help ward off pneumocystis pneumonia. People

who can't take AZT for medical reasons, or who react badly to it, may be given

DDI, the second drug approved for treatment of AIDS.

^Q:@ Magic Johnson's doctor said the athlete was leaving basketball

because playing could weaken his immune system. Can't people with HIV exercise?

^A:@ Most physicians advise their HIV-infected patients to continue

to work and exercise as long as they are physically able, for their mental

health as well as for their physical well-being. DeHovitz said he does not know

of any studies showing that heavy exertion speeds up the progression of the

disease, but said the strain of pro basketball might be tiring.

^Q:@ If Magic Johnson had chosen to continue playing basketball,

would he have posed any danger to his teammates or opponents?

^A:@ Not unless he had sex or shared needles with them. HIV

infection is not transmitted by breathing on, sweating on or touching another

individual. It is not transmitted by sharing towels or soap in the shower.

HIV is a blood-borne, viral infection that is spread by the transfusion of

infected blood and blood products, sharing contaminated needles and by sexual

activity.

^Q:@ Is it safe for a person who is HIV-positive to have sex?

^A:@ For HIV-positive people, sexual activity can range from

virtually risk-free to highly risky.

Experts agree that the safest sexual acts are those such as mutual

masturbation, in which the partners avoid contact with infected seminal or

vaginal fluids.

Vaginal intercourse is generally considered low risk as long as the male

wears a condom and the condom is used properly. Some couples prefer to use two

condoms, which further reduces risk.

Anal intercourse, whether heterosexual or homosexual, is considered a

high-risk activity, because even if a condom is used, it may tear or come off,

and there is also a high risk that infected semen deposited in the anus may

find its way into the bloodstream.

The risks of oral sex vary depending on which partner is infected. In

general, though, semen and vaginal fluids can transmit the virus, while saliva

contains the virus at concentrations believed to be too low to transmit it.

Risks can also be reduced by the wearing of a condom or a dental dam, a square

of latex in the mouth.

^Distributed by the Los Angeles Times-Washington Post News Service

LAT-WP 11-08 2107EST<