Re: Lipoatrophy (changes in body fat) in resource poor settings

October 21, 2009

Dear,

One of my patients died because of this side effect of lipoatrophy. After

surviving many years with HIV this man started getting lipoatrophy og cheeks and

people started asking him what is wrong with him?

He thought they have come to know of his disease.When he told me all, I

counseled and advised change of regimen, but he could not afford that.

Disgusted,he left the treatment as he lost faith in the ART and the outcome as

known was that he died after few months.

Another patient of mine, advocate by profession--could not accept this side

effect and commited suicide.

These two depite many successes always will haunt me in my more than a decade of

treating around 600 plus HIVvictims.

Rakesh

Dr.Rakesh Bharti,

Bharti Derma Care and Research center,

27-D,Sant Avenue,The Mall,

Amritsar143001,Punjab INDIA

Email-rakesh.bharti1@...

9814044213 / 01832277822 /01832278522

October 22, 2009

Dear Dr. Rakesh Bharti,

It is sad to read about these two incidents that you have experienced.

However, it is refreshing to see a medical person talk about psychological

impact. I mention this specifically as often times, we take a clinical

perspective of such issues, failing to acknowledge/see the psychological/social

dimensions as well.

I wish to reiterate that we must continue to do our best at all times; however,

the result is not always in our hands. We must not forget the many that have

benefited as well in the process, though it is always sad to lose a few along

the way.

Thank you doctor for writing about such a sensitive issue and sharing you

innermost feelings with us.

Maya Ramachandran

Joint Director-South India AIDS Action Programme

e-mail: <mayu_r@...>

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