 
Look How Far We’ve Come
by Liz Highleyman
Dr. Paul Volberding was on his first day on the job in the summer of 1981 when San Francisco General Hospital saw its first patient with Kaposi’s sarcoma (KS), a rare skin cancer that would become synonymous with AIDS.
“The epidemic absolutely exploded,” he says. “I talk to interns now who were born after the appearance of AIDS. They have no idea how terrible it was, how many sick young people were in hospitals during those years.”
Today, it’s a whole different ball game. “The meds today are amazingly effective, and we’ve stopped using most of the drugs that cause most of the bad side effects,” he says. “At the easiest, it’s one pill a day. At its worst, if a person can help with good adherence,
we can still usually suppress the virus even if it’s seriously resistant. HIV is now a chronic disease—which is nothing we even dreamed about early in the epidemic.”
But 25 years on, Volberding sees new challenges. “Early in the epidemic, we did HIV and only HIV. Patients came in sick, stayed sick and died,” he says. “These days, antiretroviral therapy itself is usually straightforward. But now we see patients with a broad range of internal medicine problems. Today, if you’re treating HIV, you must know your diabetes care, hypertension care and all the rest.”
And, he adds, there’s still a lot of work to be done—including expanding the benefits of new therapies to HIV-positive people in the rest of the world. “We’re not giving up on the possibility of totally eliminating the virus from the body,” he says.
Search: Kaposis sarcoma, San Francisco, Dr. Paul Volberding
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