December 11, 2009 | by David J. Hoffman
‘HIV will never be curable,’ doctor tells forum

“Get tested, listen to the experts, and lead the responsible life,” declared Michael Pistole, the sexagenarian sexologist and sometime wisecracking medical doctor speaking at a meeting on surviving the AIDS and hepatitis C viruses.

“Hepatitis C can be cured, but HIV will never be curable, since it gets into your DNA,” Pistole said.

Speaking before a group of about 100 doctors, nurses, patients and other community members gathered at the Hotel Palomar for dinner and a “Survival Forum,” Pistole summed up his message of safer sex this way: “Realize it’s not just you, it’s the rest of the world.”

Pistole’s message was punctuated by quips and risqué double-entrendres, to put people at ease and lighten the serious message about how exposure to HIV is still a real fear, while peppering the audience with sobering facts and figures underscoring that reality.

“Yes, it’s a controllable situation — with antiretroviral drugs — and you can live a normal lifespan, long enough in fact to die from something else, but we have to accept the fact that [HIV is] just like herpes, that will also never be cured, and you can’t take a vaccine for the common cold either.”

As for a vaccine to prevent exposure, he said, “I’d like to think we could get a vaccine for HIV but with the complexity of the virus, I’m not sure.” Hepatitis B, for example, has a vaccine, he pointed out, but hepatitis C does not.

As his slideshow continued, the audience could literally read the writing on the wall — currently 1.1 million adults and adolescents exposed to the virus in this country, with pockets of greater exposure according to race, ethnicity and gender.

For example, per 100,000 people in the U.S. in 2006, the most recent year for such data, there were an estimated 395 white males and 63 females exposed to the virus, compared to 2,388 African-American males and 1,122 females, and 883 Hispanic males and 263 females. Exposure rates per 100,000 people were estimated for 2006 at 220 among Asian males and 46 females and 340 American Indian and Alaska Native males and 127 females.

Pistole, 64, is an internal medicine specialist in private practice in the Washington, D.C., metropolitan area where he has been caring for HIV and hepatitis C patients since 1982. Exposure to the viruses continues, said Pistole, with risky sexual behavior rampant now in cities like D.C. where the incidence of virus carriers is skyrocketing, especially among African Americans.

According to Pistole, of total new infections recorded in 2006, 46 percent were African American, 36 percent were white, and 18 percent Hispanic, with approximately the same such proportions for men, but strikingly for women it was 61 percent African American versus 23 percent white. The highest risk factors remain IV drug use and male-to-male sexual contact, which had been decreasing as a cause of exposure but is now edging up again, said Pistole.

Among his other observations is what he called the antiviral “drug of the month” phenomenon, spurring some patients to say, “I want to try it,” something Pistole said should be discouraged by doctors.

Following his address, Pistole took questions and comments from the audience, including a memorable exchange with Michael Sainte-Andress, a 60-year-old resident of Logan Circle diagnosed with HIV in 1986.

“It’s very important to develop empowerment,” Sainte-Andress said. “You are the captain of your ship and everyone else on board is a deck hand.”

Pistole replied that “the doctor is not the captain of your ship, but he can be a little bit more than a deckhand. He can be on board as your engineer.”

Sainte-Andress is a local actor who recently played the role of Leonato in the Folger Theatre production of “Much Ado About Nothing.”

The event was sponsored by Peter Metaxotos, sole proprietor of Alpha Drugs, the Dupont Circle pharmacy at 1638 R Street, N.W., Suite 260. The next such forum, Survival Forum VIII, will be held in January with a transgender summit planned for March.

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