(organ music, dramatic lighting) "The alien entered his body. He fought to maintain control, but the visitor was too much. Over time, the visitor used him to reproducesomething it couldn't do alone" Is it Star Trek? Is it bad science fiction? Real life is stranger, yet less upsetting than fiction. We live with bacteria, viruses, and many visitors who live off of us. Often we need each other. We live with viruses which reproduce by using our cells for their purposes. HIV, unlike the normal guests, weakens us and leaves us vulnerable. HIV medicines are better than ever, as little as 1 pill per day. They are more tolerable than ever and we have many choices. Ads for HIV drugs are on buses, in magazines and websites. What are all of these and how do they work? We seek chemicals that stop the life cycle of the virus. We refine them to a purity and dose that is effective (with minimal damage to the human). Suppressing HIV is like having the exterminator come in to spray for bugs. We know that when we spray, we stop seeing the bugs-but they're not gone. A few are hiding. There are hidden eggs. We also know that using the same spray every month won't work. Over generations, bugs will evolve to be immune to the spray. We need consistent spraying and a variety of chemicals. In HIV, we always use three or more drugs at once for the same reason. And we use three drugs that each have a different attack point. What are the critical moments in the virus' life that we can attack? First, the HIV virus must find a cell to attack. It fuses with the cell. This provides a point of defense and we have one drug to prevent HIV fusion. Then the HIV virus injects its RNA genetic core into our cell. But to take over control, it must turn itself into DNA genetic material compatible with our own. Our bodies turn DNA into RNA all the time, a process called transcription. The virus goes the other way, a process called reverse transcription. Most of our current drugs stop the virus from making that compatible genetic DNA. It's a good place of attack because it's a process that the body doesn't need, but the virus does. So we can interrupt reverse transcription with little harm to the human. Next step: the new HIV DNA integrates itself with our own body's DNA. The virus is now part of us and in charge of this cell. Within a few years look for drugs preventing integration. Finally, the virus causes us to produce lots of immature proteins that when will be new adult viruses. To cut those proteins we use an enzyme called protease. Protease inhibitor drugs block the enzyme. More drugs, more ways to fight. Now we have the reality that people with HIV can live to a normal old age. Stay tuned!! Alan Amberg consulted HIV agencies all over the country for five years and currently is with C&M Pharmacy, a Walgreens Specialty Pharmacy. Reach him at 847/299-1920 or aamberg@cmpharmacy.com.