{"id":22018,"date":"2019-02-13T14:11:37","date_gmt":"2019-02-13T19:11:37","guid":{"rendered":"https:\/\/www.med.unc.edu\/medicine\/?post_type=episode&#038;p=22018"},"modified":"2023-06-06T13:51:30","modified_gmt":"2023-06-06T17:51:30","slug":"hiv-treatment","status":"publish","type":"episode","link":"https:\/\/www.med.unc.edu\/medicine\/news\/chairs-corner\/podcast\/hiv-treatment\/","title":{"rendered":"HIV Treatment &#8211; with Dr. Joe Eron"},"content":{"rendered":"<h5>How effective is HIV treatment today? What sorts of side effects do they cause? Dr. Joe Eron addresses concerns and questions related to HIV medications in this HIV Matters episode. He explains how they work in the body, and describes the latest research being done to improve treatment. Dr. Eron is Professor of Medicine and Vice Chief of the Division of Infectious Diseases.<\/h5>\n<div class=\"image-section\">\n<figure class=\"thumbnail wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium\" src=\"https:\/\/www.med.unc.edu\/medicine\/wp-content\/uploads\/sites\/945\/2018\/12\/hiv-treatment-image2.jpeg\" alt=\"image2\" width=\"300\" height=\"200\" \/><figcaption class=\"caption wp-caption-text\">Joe Eron, MD<\/figcaption><\/figure>\n<\/div>\n<h5>\u201cThe therapy now is, for almost every patient who comes in who is newly diagnosed, they can be treated with <b>one<\/b> pill <b>once<\/b> a day. It\u2019s a combination pill\u2014it\u2019s got multiple medicines in it, but it\u2019s one pill once a day. All pills have side effects\u2026 but they tend to be pretty mild. Literally, I tell people- &#8216;<i>If you take it, you will respond.<\/i>\u201d<\/p>\n<p>\u2013 Dr. Joe Eron<\/h5>\n\n<!-- iframe plugin v.5.2 wordpress.org\/plugins\/iframe\/ -->\n<iframe loading=\"lazy\" width=\"100%\" height=\"166\" scrolling=\"no\" frameborder=\"no\" src=\"https:\/\/w.soundcloud.com\/player\/?url=https%3A\/\/api.soundcloud.com\/tracks\/391902933%3Fsecret_token%3Ds-BffBA&#038;color=%235fa6dd&#038;inverse=true&#038;auto_play=false&#038;show_user=true\" class=\"iframe-class\"><\/iframe>\n\n&lt;!&#8211;<span class=\"btn btn-dark btn-large\">\n<!-- iframe plugin v.5.2 wordpress.org\/plugins\/iframe\/ -->\n<iframe loading=\"lazy\" width=\"350\" height=\"20\" scrolling=\"no\" frameborder=\"no\" src=\"https:\/\/w.soundcloud.com\/player\/?url=https%3A\/\/api.soundcloud.com\/tracks\/391902933%3Fsecret_token%3Ds-BffBA&#038;color=%235fa6dd&#038;inverse=false&#038;auto_play=false&#038;show_user=true\" class=\"iframe-class\"><\/iframe>\n <\/span>&#8211;&gt;<\/p>\n<p><b> Specific Topics Covered:<\/b><\/p>\n<ul>\n<li>Talking about fear and stigma<\/li>\n<li>Starting treatment for HIV<\/li>\n<li>Consequences of not taking medicines<\/li>\n<li>How long it takes the drugs to work &amp; how they work<\/li>\n<li>Commonly asked questions about HIV medicines<\/li>\n<li>Current research in HIV treatment<\/li>\n<li>Changes in HIV outlook over the last twenty-five years<\/li>\n<\/ul>\n<p><b>Ron Falk, MD:<\/b> Hello, and welcome to the Chair\u2019s Corner from the Department of Medicine at the University of North Carolina. This is our series for patients where we talk about HIV. In previous episodes, we discussed PrEP, we\u2019ve talked about getting clinical care for HIV, and today we will focus on treating HIV.<\/p>\n<p>We welcome <a class=\"external-link\" title=\"\" href=\"https:\/\/www.med.unc.edu\/medicine\/directory\/joseph-eron-md\/\" target=\"_blank\" rel=\"noopener\">Dr. Joe Eron<\/a>, who is a Professor of Medicine and Vice Chief of our Division of Infectious Diseases, and while he looks remarkably young, he has a very long history of treating patients with HIV. Welcome, Dr. Eron.<\/p>\n<p><b>Joe Eron, MD:<\/b> Thanks for inviting me. This is really going to be fun.<\/p>\n<h3><span class=\"blue\">Talking about fear and stigma<\/span><\/h3>\n<p><b>Falk: <\/b>When you have a patient who has recently found out that they have HIV, and you\u2019re about to begin treatment, what kinds of thing do people talk to you about? What concerns do they have?<\/p>\n<p><b>Eron:<\/b> Well, I think there\u2019s still so much misimpression or bad information about HIV. Patients still come in thinking, <i>I\u2019ve got a fatal disease. I\u2019m going to die from this. <\/i>That\u2019s the most common thing.<\/p>\n<p><b>Falk:<\/b> In 2018, that\u2019s amazing.<\/p>\n<p><b>Eron:<\/b> Right, in 2018. I spend a lot of time talking to them about how they\u2019re actually going to live. We have therapy that\u2019s pretty straightforward. It\u2019s not that hard anymore. I really try talk to them about what they\u2019re going to do in their life to change what\u2019s happened that got them into this situation, but lots of times I have people who have been infected for years sometimes and they\u2019re just diagnosed\u2014and they\u2019re devastated, and they\u2019ve kind of moved past that part of their life. They\u2019re devastated. They think, <i>I\u2019ve escaped from my bad behavior or risky behavior from ten years ago<\/i>, and then they think<i>, Oh my God, I didn\u2019t escape. I can\u2019t believe I have this.<\/i> So, dealing with that fear, that <i>I\u2019m going to die.<\/i> The other thing is<i>, I can\u2019t possibly let anyone know.<\/i><\/p>\n<p><b>Falk:<\/b> Embarrassment.<\/p>\n<p><b>Eron:<\/b> Embarrassment, stigma\u2014exactly. Those are the two biggest things\u2014the fear of the disease itself, and the fear of being isolated and just not being able to let anyone know about what\u2019s happened to them.<\/p>\n<p><b>Falk:<\/b> In reality though, the therapy is remarkably good.<\/p>\n<p><b>Eron:<\/b> Right. The therapy now is, for almost every patient who comes in who is newly diagnosed, they can be treated with one pill once a day. It\u2019s a combination pill\u2014it\u2019s got multiple medicines in it, but it\u2019s one pill once a day. All pills have side effects as you know, but they tend to be pretty mild. Literally, I tell people- \u201c<i>If you take it, you will respond.\u201d <\/i>The issues are really getting people to take it. It sounds like, <i>\u201cOh anyone can take one pill once a day for near fatal disease,\u201d<\/i> but it\u2019s not so easy.<b> <\/b><\/p>\n<p><b>Falk:<\/b> Right.<\/p>\n<p><b>Eron:<\/b> So, they need to take the pill, and if they have a problem, they need to communicate and say, <i>\u201cThis isn\u2019t working for me.\u201d<\/i> But most people do pretty well.<\/p>\n<p><b>Falk:<\/b> How do you help with the stigma issue?<\/p>\n<p><b> Eron:<\/b> The stigma issue is a lot harder. It\u2019s funny, there are data that suggest if someone comes to their first HIV appointment with someone else, they do so much better, because they\u2019ve already been able to tell somebody something. So, for dealing with the stigma, I ask them if there\u2019s someone they can bring to their appointment with them, someone I can talk to\u2014a partner, brother, sister, a parent, or a child\u2026but I think the stigma really is a huge problem.<\/p>\n<p><b>Falk:<\/b> Having an advocate though, regardless of the disease, in the room with you is always a good idea.<b> <\/b><\/p>\n<p><b>Eron:<\/b> Yes, for anyone listening to this podcast, that\u2019s one piece of medical information, anytime you encounter the health care system, to have someone who\u2019s an advocate who can listen with you, because\u2026I hear half the things you say. I try to hear the good things you say, but it\u2019s stressful, it\u2019s hard, you don\u2019t know what people hear when you talk to them. Having another set of ears there makes a big difference. It really helps.<\/p>\n<h3><span class=\"blue\">Starting treatment for HIV<\/span><\/h3>\n<p><b>Falk:<\/b> When should someone with HIV start treatment? Is there a magic moment?<\/p>\n<p><b>Eron:<\/b> There used to be a magic moment. We used to argue all the time about which stage of disease should we start treatment, and in part it was because we were worried that one, our treatments in the past were more toxic than we wanted them to be\u2014they had more side effects.<\/p>\n<p>The other thing is, we worried that the virus would become resistant, so we would wait. That\u2019s pretty much over. Mike Cohen, who works with both of us, helped show that really, starting therapy as early as possible is beneficial to patients. We try to get people on therapy within one or two visits after seeing them. There are places in the country where they\u2019re starting treatment at the patient\u2019s first visit, because there\u2019s some evidence that if you give people a therapy, they can embrace it\u2014that <i>this is a serious illness, this is something I should be doing, why wait<\/i>? We don\u2019t wait now. We start right away.<b> <\/b><\/p>\n<p><b>Falk:<\/b> First visit.<\/p>\n<p><b>Eron:<\/b> First visit\u2014in our clinic, it\u2019s usually the second visit, because we have to organize how they\u2019re going to get their medicine, to make sure their insurance is together. We might need to use our Ryan White program, which is a federal program that helps patients get medication. So, it\u2019s usually the second visit we start.<\/p>\n<p><b>Falk:<\/b> The fear of resistant virus. Is that completely gone away?<\/p>\n<p><b>Eron:<\/b> No, it\u2019s not gone, but it\u2019s diminished. We\u2019ve studied this in our clinic pretty carefully, and you can see the proportion of patients with resistance declining over time, but there is transient resistance. Some patients show up, having been infected with a virus that\u2019s resistant, but for the most part, we can deal with that very, very easily.<\/p>\n<p><b>Falk:<\/b> With other drugs.<\/p>\n<p><b>Eron:<\/b> With other drugs, right. We get a resistance test at baseline so we can check to see what would be the best therapy for an individual patient, and we have enough drugs now that it\u2019s really not an issue. It\u2019s good in a way, our trainees, our fellows know much less about resistance now than our trainees from five or ten years ago, because we\u2019re just not seeing it as much. The HIV virus is tricky, so I would never say resistance is not a problem, but it\u2019s a much, much smaller problem.<\/p>\n<h3><span class=\"blue\">Consequences of not taking medicines<\/span><\/h3>\n<p><b>Falk:<\/b> What do you tell a person who says, <i>\u201cLook, I\u2019ve been living with HIV for the last X number of years, I\u2019m feeling fine, I\u2019m not going to infect anyone else, I\u2019m living by myself.\u201d<\/i> What are the consequences of not receiving treatment?\u201d<\/p>\n<p><b>Eron:<\/b> We do hear that, because a lot of people don\u2019t want to take medicines. They don\u2019t want to be reminded that every day they have HIV infection. What we now know is that not only are there these AIDS consequences that people hear about, AIDS-defining illnesses, but things like kidney disease, which obviously you\u2019re an expert in\u2014liver disease, heart disease, are all more likely in patients who have their virus replicating, not suppressed. Turns out there\u2019s quite a bit of immune activation, their immune systems are revved up, they have a lot of inflammation which affects blood vessels, which affects the kidney, which affects the liver.<\/p>\n<p>So, that patient that you described, that takes a little bit of effort. I have to see that person back and try to talk about these other consequences of having a virus replicating in your body. People can sometimes visualize that, we can measure viral loads and say, \u201c<i>Look, you have 10,000 copies of the virus in your blood<\/i>,\u201d and sometimes that helps. I do get that from people, and it does take a little bit of effort sometimes to convince them that if they\u2019re feeling well, that it\u2019s better to go on treatment.<\/p>\n<p><b>Falk:<\/b> I take care of people with high blood pressure, and you only know you have high blood pressure if you stick your arm in a blood pressure cuff. The reality is you\u2019re going to take a blood pressure medicine\u2014or two or three, sometimes\u2014and that seems like most people usually do it. Why wouldn\u2019t you expect that most people would usually being willing to take a single drug? Is there some other issue?<\/p>\n<p><b>Eron:<\/b> I think that the vast majority are willing. If you look at our clinic, the goal of therapy now is to get the virus level below what we can measure. That\u2019s not just because we\u2019re all just number crazy, but the virus is like a slot machine\u2014turning, turning, turning. If you can slow that slot machine down, you can end up preventing that virus from becoming resistant. If you can get replication down to zero or close to zero, then you won\u2019t become resistant to the therapies. If you look at our clinic, between eighty-five and ninety percent of all the patients in the clinic have a viral load that\u2019s below what we can measure.<\/p>\n<p><b>Falk:<\/b> Which is protective for everyone around them.<\/p>\n<p><b>Eron:<\/b> Right, and being undetectable means that you are virtually untransmissable. In fact, that\u2019s what the CDC now says: Undetectable means untransmissable.<\/p>\n<h3><span class=\"blue\">How long it takes the drugs to work &amp; how they work<\/span><\/h3>\n<p><b>Falk:<\/b> That\u2019s just fantastic. How long does it take for these drugs to work?<\/p>\n<p><b>Eron:<\/b> That\u2019s the amazing thing. If you take them, they work incredibly well. If your viral load is 100,000, by four weeks it should be 1,000 or less. It shoots down dramatically fast. I know, for example, if I see a patient and they come back four weeks later and their virus level hasn\u2019t really changed, either they didn\u2019t get the medicine, they didn\u2019t take the medicine, or I gave them the wrong medicine or the wrong instruction. That virus level is a barometer\u2014it happens very quickly. The immune system recovers more slowly, but the virus suppression happens quickly.<\/p>\n<p><b>Falk:<\/b> There are multiple different kinds of HIV drugs. They work differently. Help me understand a little bit how they work.<\/p>\n<p><b>Eron:<\/b> The virus essentially has to hijack the machinery of the cell. It\u2019s like someone coming in to a factory and kind of taking over that factory. The virus has three key steps where it uses its own information. It has to change its genetic material, its blueprint from RNA to DNA, so if you block that, \u201c<b>reverse transcription<\/b>,\u201d that\u2019s one step. It has to integrate, it has to get into the patient\u2019s DNA, into the chromosome, and that\u2019s another virus step, so we block that, we block the \u201c<b>integrase<\/b>.\u201d Then finally, when the virus has to come out of the cell, it has to take its proteins and construct the capsule, the thing that carries the virus\u2019s genetic material, the virus blueprint. That\u2019s done with a <b>protease<\/b>. Three enzymes: <b>reverse transcriptions, integrase<\/b>, and <b>protease<\/b>, those are our main weapons.<\/p>\n<p><b>Falk:<\/b> In one pill.<\/p>\n<p><b>Eron:<\/b> In one pill. Usually it\u2019s two of one, and one of the other, and we kind of mix and match, but we\u2019re actually getting pretty good at this over time.<\/p>\n<p><b>Falk:<\/b> Thank goodness. Let\u2019s say the person\u2019s viral load is undetectable. What\u2019s the life span?<\/p>\n<p><b>Eron:<\/b> The predictions now are\u2014for example, someone twenty-five years old, starts on therapy and can stay on therapy\u2014the predicted life span based on these complicated models is fifty years. Fifty to sixty years, so seventy-five or eighty. It\u2019s not, it doesn\u2019t quite reach the normal life expectancy, we think in part because there\u2019s some intrinsic damage done to the immune system in that period before you get on therapy, so we still have work to do, to get people\u2019s immune systems back to perfect health. Of course, the longer you\u2019ve waited to get on therapy, the harder it is to get it back, so that\u2019s a big issue.<\/p>\n<p><b>Falk:<\/b> Arguing for early therapy.<\/p>\n<p><b>Eron:<\/b> Strongly arguing for early therapy.<\/p>\n<p><b>Falk:<\/b> You said you could mix and match. How do you actually figure out what you\u2019re mixing and matching?<\/p>\n<p><b>Eron:<\/b> One of the things I\u2019ve done, and here at UNC, we\u2019ve done, is really done those combination comparative trials, we\u2019ve done really scores of them\u2014sixty, seventy, eighty trials. We were one of the very first sites that did that first cocktail study\u2014you\u2019ve seen the pictures in <i>Time<\/i> magazine, of the handful of pills\u2014we were one of the first sites to do that cocktail study to show that it took three drugs together, and over the years we\u2019ve done multiple refinements of comparative studies. I\u2019m really proud of the work that our collective research group, both here and globally, has done to refine the right combinations. There still may be better ones, but literally, when we do a study now, after a year, ninety-two or ninety-three of the patients are suppressed on the medication that we pick, five percent go off the study for all of the reasons that have nothing to do with the treatment\u2014they move, they quit the study\u2014and one or two percent fail.<\/p>\n<p><b>Falk:<\/b> That\u2019s just remarkable.<\/p>\n<p><b>Eron:<\/b> You can\u2019t do better. We\u2019re basically trying to refine toxicities and make sure people are on the safest medicine possible.<\/p>\n<h3><span class=\"blue\">Commonly asked questions about HIV medicines<\/span><\/h3>\n<p><b>Falk:<\/b> What kind of questions do patients ask you about these medicines?<\/p>\n<p><b>Eron:<\/b> Well, they always ask, <i>\u201cHow long will I need to take it?\u201d<\/i> That\u2019s one of the hardest conversations, because I say, <i>\u201cWell, as long as you live, probably.\u201d<\/i> Now, you\u2019re going to talk later to Dr. Margolis, who\u2019s our great hope for curing HIV, and the patients do ask about that: <i>\u201cWill there ever be a cure?\u201d<\/i> They ask about how long they\u2019ll need to take it, they ask about side effects, they ask about things that are common in your life. <i>Can I have to take it with food? Do I have to take it at night? What if I miss by an hour?<\/i>\u2014those are the hyper-compulsive ones. Those are the kind of things that people ask. They\u2019re worried about taking it for a long time, and they\u2019re worried about side effects that will impact their life.<\/p>\n<p><b>Falk:<\/b> What side effects are there?<\/p>\n<p><b>Eron:<\/b> Right now, the ones that patients worry about are really pretty uncommon now. We used to give people medicines they would take every six hours on the clock and set a timer. They\u2019d have to drink a couple gallons of water, they\u2019d have nausea, they\u2019d have diarrhea. Now, the side effects are pretty minor. People do get some stomach upset, but that\u2019s a minor one. The ones I worry about aren\u2019t necessarily the things that they feel. Some of our drugs do impact the kidney, so we have to monitor kidney function. One class of our drugs raises cholesterol a bit, so we have to keep our eyes on that. If you had told me twenty-five years ago I would be worried about my patient\u2019s cholesterol, I would have said, \u201c<i>You\u2019re out of your mind!\u201d<\/i> Now, that\u2019s what I do now, I worry about cholesterol.<\/p>\n<p><b>Falk:<\/b> Happily, and kidney function, which everybody needs to worry about!<\/p>\n<p><b>Eron:<\/b> And blood pressure. I worry about all of those things now. It\u2019s amazing.<\/p>\n<p><b>Falk:<\/b> That\u2019s great. What happens if someone forgets to take their pill?<\/p>\n<p><b>Eron:<\/b> Now, that\u2019s an issue. One of the things that has been so successful in our drug development is we have drugs that have pretty long half-lives, so probably missing a pill here or there, especially once they\u2019ve gotten their virus suppressed, is not as dangerous as it used to be. We used to say that you had to be ninety-percent adherent to be successful, but I can promise you, our clinic, with ninety percent of people suppressed, ninety percent of our two thousand patients are not taking their pills every single day, because they\u2019re all human like me and you, and we miss now and then.<\/p>\n<p><b>Falk:<\/b> Missing for an hour or two\u2026<\/p>\n<p><b>Eron:<\/b> Not a problem. The issues are, people who either lose access to their therapy, or somehow become either compromised because of life situations like depression, substance use, insurance\u2026<\/p>\n<p><b>Falk:<\/b> Something happens.<\/p>\n<p><b>Eron:<\/b> It\u2019s those big gaps in therapy that matter, where they stop for a week or a month, and as the drug level goes down, that wheel starts spinning. Once it starts replicating, you get mutations, and some of those mutations lead to resistance.<\/p>\n<p><b>Falk:<\/b> That\u2019s of course what one is trying to avoid at all cost. What do you do if somebody does get resistant disease?<\/p>\n<p><b>Eron:<\/b> If it turns out that someone\u2019s been on therapy, and their virus level comes up, first we get a resistance test. We have a lot of information about what drugs work against these specific resistant viruses, so that the problem there is that therapies get more complicated. There aren\u2019t as many single tablets that you can give to someone who is resistant to a couple of those classes that I talked about\u2014reverse transcriptase, integrase, protease, so then the therapy gets a little more complicated. It\u2019s a little harder to take, so you\u2019re in that space where someone had trouble taking a simple therapy, and then you\u2019ve got to give them a more complicated therapy. Then they need more support\u2014they need phone support. We have a really strong social work and pharmacy staff that will call people, help them with refills, but that\u2019s when it gets tricky.<\/p>\n<p><b>Falk:<\/b> In reality though, the message has got to be, start early, take it every day, and just don\u2019t think about it.<\/p>\n<p><b>Eron:<\/b> What I tell people, if they\u2019re a woman and they\u2019re child bearing<i>, \u201cDo you want to have kids? It\u2019s okay<\/i>.\u201d If they already have kids, I say, \u201c<i>Save for college\u2014have that child go farther as you want them<\/i>.\u201d If they\u2019re a little older, I say, <i>\u201cSave for retirement\u2014you can live a normal life<\/i>.\u201d That\u2019s what I try to tell them as best as I can.<\/p>\n<h3><span class=\"blue\">Current research in HIV treatment<\/span><\/h3>\n<p><b>Falk:<\/b> Right. Let me ask an obvious question: You\u2019ve made tremendous progress and we\u2019re all hoping that there will be a cure, but on the near horizon, is there going to be every-other-day therapy, or is there going to be an opportunity to stop?<\/p>\n<p><b>Eron:<\/b> Super question. There are a couple of things we\u2019re doing. There\u2019s a move now to develop longer-acting therapies\u2014injectable therapies. In fact, we have a study going now where you can get an injection of two drugs and we\u2019ve learned that if you\u2019re suppressed, two drugs work, and the study is comparing monthly injections with every-other-month injections.<\/p>\n<p><b>Falk:<\/b> Wow.<\/p>\n<p><b>Eron:<\/b> Now, the intramuscular injections are a little bit tough, but it\u2019s moving in that direction. There\u2019s another new drug that\u2019s recently been discovered that is incredibly potent, which means you can give very small amounts of it. It\u2019s possible that this drug could be put in one of those devices that they use for pregnancy prevention, for contraception, one of those long-acting Implanon or Nexplanon devices, so we really are thinking about how we might be able to give people therapy on a quarterly basis or even a six month basis.<\/p>\n<p><b>Falk:<\/b> That would be amazing.<\/p>\n<p><b>Eron:<\/b> Sort of like what was done in osteoporosis\u2014started out as a pill, was a monthly, and some people get once a year infusions for their osteoporosis, so it\u2019s possible. That\u2019s kind of the new frontier that we\u2019re really working on.<\/p>\n<h3><span class=\"blue\">Changes in HIV outlook over the last twenty-five years<\/span><b> <\/b><\/h3>\n<p><b>Falk:<\/b> Help me reflect for a moment. Now you\u2019re describing a medicine that you regularly could take once a day, you\u2019re describing in the near term that there may be drugs that you could use every other month or perhaps quarterly\u2014recycle back twenty, twenty-five years ago. What was it like then?<\/p>\n<p><b>Eron:<\/b> This is something that I\u2019ll never forget. When I first came here to UNC in 1992, we literally had people die every week. There was another person who we knew and took care of who died that week and we really were kind of caretakers and helping people through the last stages of a fatal illness. It\u2019s just been totally transformed. Now, it\u2019s rare that one of my patients dies. Sometimes they do. I recently had a patient die almost of old age\u2014they had cancer, but they were in their late seventies, almost eighty years old, their family was around them, and they died from something other than HIV. It was just incredibly different. That\u2019s what I\u2019m hoping for all of my patients.<\/p>\n<p><b>Falk:<\/b> Die with your HIV, but not from your HIV.<\/p>\n<p><b>Eron:<\/b> Exactly.<\/p>\n<p><b>Falk:<\/b> That\u2019s a wonderful thought.<\/p>\n<p><b>Eron:<\/b> It is.<\/p>\n<p><b>Falk:<\/b> Thank you, Dr. Eron, for a really informative discussion.<\/p>\n<p><b>Eron:<\/b> This was really fun, thanks for inviting me.<b> <\/b><\/p>\n<p><b>Falk:<\/b> Thanks so much to our listeners for tuning in. In our next episode, we\u2019ll be joined by Dr. David Wohl, for a discussion on managing your health and aging with HIV. If you enjoy this series, you can <a href=\"https:\/\/itunes.apple.com\/us\/podcast\/unc-department-of-medicine-chairs-corner\/id1076686662?mt=2\" target=\"_blank\" rel=\"noopener\">subscribe to the Chair\u2019s Corner on iTunes<\/a> or <a href=\"https:\/\/www.facebook.com\/UNCDeptMedicine\" target=\"_blank\" rel=\"noopener\">like the UNC Department of Medicine on FaceBook<\/a>. Thanks so much.<\/p>\n<div class=\"alert alert-blue width:100% \">\n<p><strong>Visit these sites for more information:<\/strong><\/p>\n<ul>\n<li><a class=\"external-link\" title=\"\" href=\"https:\/\/www.med.unc.edu\/medicine\/directory\/joseph-eron-md\/\" target=\"_blank\" rel=\"noopener\">Dr. Joe Eron&#8217;s School of Medicine profile<\/a><\/li>\n<li><a class=\"external-link\" title=\"\" href=\"https:\/\/www.med.unc.edu\/medicine\/infdis\/patient-care\/infectious-diseases-clinic\/\" target=\"_blank\" rel=\"noopener\">Infectious Diseases (ID) Clinic at UNC<\/a><\/li>\n<li><a class=\"external-link\" title=\"\" href=\"https:\/\/www.preventionaccess.org\" target=\"_blank\" rel=\"noopener\">Prevention Access Campaign<\/a><\/li>\n<li><a id=\"LPlnk776044\" href=\"http:\/\/www.thebody.com\/\">TheBody.com<\/a><\/li>\n<li><a class=\"external-link\" title=\"\" href=\"http:\/\/globalhealth.unc.edu\" target=\"_blank\" rel=\"noopener\">UNC Institute for Global Health and Infectious Disease<\/a><\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n<p>\/\/ <\/p>\n","protected":false},"excerpt":{"rendered":"<p>How effective is HIV treatment today? What sorts of side effects do they cause? Dr. Joe Eron addresses concerns and questions related to HIV medications in this HIV Matters episode. He explains how they work in the body, and describes the latest research being done to improve treatment. Dr. Eron is Professor of Medicine and &hellip; <a href=\"https:\/\/www.med.unc.edu\/medicine\/news\/chairs-corner\/podcast\/hiv-treatment\/\" aria-label=\"Read more about HIV Treatment &#8211; with Dr. Joe Eron\">Read more<\/a><\/p>\n","protected":false},"featured_media":4170,"menu_order":0,"template":"","meta":{"_acf_changed":false,"layout":"","cellInformation":"","apiCallInformation":"","_links_to":"","_links_to_target":""},"podcast-category":[636,639],"class_list":["post-22018","episode","type-episode","status-publish","has-post-thumbnail","hentry","podcast-category-podcast-hiv-matters","podcast-category-podcast","odd"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>HIV Treatment - with Dr. Joe Eron | Department of Medicine<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.med.unc.edu\/medicine\/news\/\/news\/chairs-corner\/podcast\/hiv-treatment\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"HIV Treatment - with Dr. Joe Eron | Department of Medicine\" \/>\n<meta property=\"og:description\" content=\"How effective is HIV treatment today? What sorts of side effects do they cause? Dr. Joe Eron addresses concerns and questions related to HIV medications in this HIV Matters episode. He explains how they work in the body, and describes the latest research being done to improve treatment. Dr. Eron is Professor of Medicine and &hellip; Read more\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.med.unc.edu\/medicine\/news\/\/news\/chairs-corner\/podcast\/hiv-treatment\/\" \/>\n<meta property=\"og:site_name\" content=\"Department of Medicine\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/UNCDeptMedicine\" \/>\n<meta property=\"article:modified_time\" content=\"2023-06-06T17:51:30+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.med.unc.edu\/medicine\/wp-content\/uploads\/sites\/945\/2018\/12\/hiv-treatment-image2-scaled.jpeg\" \/>\n\t<meta property=\"og:image:width\" content=\"2560\" \/>\n\t<meta property=\"og:image:height\" content=\"1714\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:site\" content=\"@uncdeptmedicine\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"20 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.med.unc.edu\/medicine\/news\/\/news\/chairs-corner\/podcast\/hiv-treatment\/\",\"url\":\"https:\/\/www.med.unc.edu\/medicine\/news\/\/news\/chairs-corner\/podcast\/hiv-treatment\/\",\"name\":\"HIV Treatment - with Dr. Joe Eron | Department of Medicine\",\"isPartOf\":{\"@id\":\"https:\/\/www.med.unc.edu\/medicine\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/www.med.unc.edu\/medicine\/news\/\/news\/chairs-corner\/podcast\/hiv-treatment\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/www.med.unc.edu\/medicine\/news\/\/news\/chairs-corner\/podcast\/hiv-treatment\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/www.med.unc.edu\/medicine\/wp-content\/uploads\/sites\/945\/2018\/12\/hiv-treatment-image2-scaled.jpeg\",\"datePublished\":\"2019-02-13T19:11:37+00:00\",\"dateModified\":\"2023-06-06T17:51:30+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/www.med.unc.edu\/medicine\/news\/\/news\/chairs-corner\/podcast\/hiv-treatment\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/www.med.unc.edu\/medicine\/news\/\/news\/chairs-corner\/podcast\/hiv-treatment\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/www.med.unc.edu\/medicine\/news\/\/news\/chairs-corner\/podcast\/hiv-treatment\/#primaryimage\",\"url\":\"https:\/\/www.med.unc.edu\/medicine\/wp-content\/uploads\/sites\/945\/2018\/12\/hiv-treatment-image2-scaled.jpeg\",\"contentUrl\":\"https:\/\/www.med.unc.edu\/medicine\/wp-content\/uploads\/sites\/945\/2018\/12\/hiv-treatment-image2-scaled.jpeg\",\"width\":2560,\"height\":1714,\"caption\":\"Joe Eron, MD\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/www.med.unc.edu\/medicine\/news\/\/news\/chairs-corner\/podcast\/hiv-treatment\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/www.med.unc.edu\/medicine\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Podcasts\",\"item\":\"https:\/\/www.med.unc.edu\/medicine\/news\/\/news\/chairs-corner\/podcast\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"HIV Treatment &#8211; with Dr. Joe Eron\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/www.med.unc.edu\/medicine\/#website\",\"url\":\"https:\/\/www.med.unc.edu\/medicine\/\",\"name\":\"Department of Medicine\",\"description\":\"\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/www.med.unc.edu\/medicine\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"HIV Treatment - with Dr. Joe Eron | Department of Medicine","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.med.unc.edu\/medicine\/news\/\/news\/chairs-corner\/podcast\/hiv-treatment\/","og_locale":"en_US","og_type":"article","og_title":"HIV Treatment - with Dr. Joe Eron | Department of Medicine","og_description":"How effective is HIV treatment today? 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