Here’s the story of another not so angelic patient.
A man with HIV infection for almost a decade has been faithfully coming for followup at my clinic. Because he has been started on HAART, he is doing quite well. In one of his recent visit to the clinic, he brought up the issue of his wife not being in the best of health lately. Apparently she has had a bout of fever and cough which apparently resolved on taking some medications.
On further inquiry, I discovered that the wife is also HIV positive for almost as long as the husband but has never been on any follow-up because she felt well and healthy and did not feel the need to see a doctor. Being concerned, I asked the husband to bring his wife in his next followup so that her health can be monitored.
A few months later, the patient came with his wife. After seeing the husband, I asked him to leave the clinic so that I take the history and examine the wife.
It was in the course of history taking that I discovered, to my horror, that the husband has been sharing his medications with his wife!!! For instance, when the wife had that bout of fever recently, the husband gave her some of the antibiotics that he is taking regularly for prophylaxis against PCP infection (a respiratory infection caused by an opportunistic fungus). On top of that he also gave her some of his anti-HIV medication which she takes as and when she felt unwell!!! All this have been going on for almost a year!
I guess it is one way the husband shows that he cares for his wife but to a physician treating HIV patients, this is a nightmare!!!! HIV, unlike other chronic illnesses like diabetes mellitus where medications can be shared between fellow diabetics, is unique in the sense that the available medications to treat HIV are often individualized and the patient has to follow a strict and committed regimen in order to stay healthy. Anyone who takes these medications at their own whims and fancies are liable to suffer the side effects of the medications as well as potentially contribute to HIV drug resistance which would render the medications useless in the future.
In short, HIV medications are often a use-only-once regimen wherein its failure would result in using other medications which are more expensive and have worst side effects.
I am now unsure if the HIV in the wife is already resistant to the medications that her hubby has been feeding her intermittently!
It’s ironic that in his concern and care for his wife, the husband may have indirectly condemned his wife to further misery!
Thurs, 150410 @ 1614