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After Quitting Illegal Drugs, Patient Is Skeptical of New Medicine
By David Brown BALTIMORE — Not everyone who comes to the Imani Center necessarily wants to take the new medicines for HIV infection. Lawrence Hantz, a 36-year-old patient, has his own list of reasons: The antiviral drugs don't cure; they were originally experimental; they were first tried on animals. Plus, he adds: "Everyone who I've ever seen take the medicine has died." His observations are all correct, including the last one. For more than a decade, the rule of HIV care has been that antiviral drugs may help for a while, but eventually a patient goes downhill and dies of complications from AIDS. What makes the new world of triple therapy so exciting is that Hantz's observation may be obsolete. The new AIDS drugs may work well enough, and long enough, that everyone taking them won't eventually die of AIDS. Hantz, in fact, may be the perfect triple therapy candidate. He has never been sick from his HIV infection. Although about half of all people progress to AIDS in the decade after they're infected, Hantz has followed a different, far rarer course. He's gotten better. His CD4 cell count -- sometimes also called the T-cell count — increased from 360 a year ago to 587 in February. In his case, almost certainly part of the reason for the rise was that he stopped injecting cocaine and heroin in the interim. On this particular day, waiting for his doctor's appointment at the Imani Center, Hantz looks great — a strong body surmounted by a handsome, shaved head. He's full of energy and ready to take on Baltimore's mayor about a locked-up playground in his neighborhood, to talk about a nonprofit organization called LOVE, for "Lift Our Voices Everywhere," or just to tell you the story of his life, no detail spared. He was once a professional cook. He was once a student at Baltimore's respected Culinary Arts Institute. But long ago, he also became a drug addict. He took a long free-fall into a world of degradation, abandoned houses and dangerous acts. In late 1988, he learned he was HIV-positive. The revelation caused great trauma in his family, with some bonds broken and others cinched more tightly. It was part of his passage in recent years toward self-knowledge and hope. Last November, Hantz reached another milestone when he quit drugs. He talks of himself as a saved man, free at last of his secrets, and of many of his fears. "The only thing that I think has been keeping me healthy is coming out of that denial and accepting this disease. Teaching other people, talking about it, and just putting it in the hands of the Lord," he says. "When I come in here, we talk about five minutes about my T-cells, and half an hour about my personal life." On this clinic visit, however, Hantz learns that for the first time his viral load has risen. It's now 6,000. Not high, but no longer "undetectable" either. Chukwuemeka Ufomadu, the doctor, is uncertain what to make of it, given the rising CD4 count. The tests will be repeated. Nevertheless, it seems likely that sometime in the future, patient and doctor will face the issue of whether to start triple therapy. It would look to be a hard sell, and an ironic situation -- a good candidate for treatment who doesn't want it. Does Ufomadu think he can convince him? The doctor has no doubts. "I think I will be successful with this patient," he says in his clipped West African tones. "When he comes in, the first thing he wants to do is look at his numbers."
© 1997 The Washington Post Company
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