G

Yesterday afternoon, bright and sunny, bitterly cold but no deterrent to sitting on the Terrace of the Engel and drinking coffee/wine with the other regulars.

And then there was a blast from the past, G. Never a friend, nor really an acquaintance. More someone who I would have liked to have spent more time with over the past 20+ years. Our paths crossed and uncrossed at regular but sparse intervals over the years. He witnessed my ex, the downfall of said relationship, my various career moves without being an integral part of them.

A lovely man, a gentle man, a proud man.

So he sits down and tells me he has 8 to 9 months left to live because he has liver cancer.

With the directness that seems to be the sole right of terminally ill people I get the story, although honesty demands that I say that I did push slightly.

A long term survivor of hiv, he has been medicated since lord knows when. AZT, mono-therapy, cocktails, protease inhibitors etc etc etc. That he's had Chronic Hepatitis B for years hasn't helped his liver functions. But that isn't what's killing him.

Every 3 months we go to the hospital to get our CD4 and VL counts and then we are sent home till the next time. As if that's all a doctor needs to know to declare us healthy. We know that hiv drugs are harmful to our bodies, but that seems to get overlooked. Screening for liver functions once a year clearly isn't enough, but why doesn't it happen more often? Anal cancer only gets tested if the patient has clear symptoms, but it can be present in the body for months before it becomes a problem. Low hormone levels, an indication of what? Hiv is a chronic disease, why don't we get full screening? Too expensive?

Of course other people get cancer, and liver cancer is notoriously untreatable, and there is not necessarily a connection but is it not time that we looked at the consequences of long term antiretroviral use?

This is 2 people in the last few months who we thought were going to live as long as their hiv negative counterparts through the miracle of modern science and the benevolence of pharmaceutical companies.

Trust your body, mistrust figures, demand facts.