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December 19, 2009

North Country HIV doctor cited for work ethic

[-BULLET-] Award-winning Rietsema leads charge in combating infection

By JEFF MEYERS

PLATTSBURGH — Humanity's battle against HIV has taken many twists and turns over the past several decades.

Although science has yet to find a cure for this dreaded infection, medicine has helped improve a person's odds against developing full-blown AIDS and facing a likely death sentence.

Dr. Wouter Rietsema, an infectious-disease specialist practicing at the CVPH Health Center, has lead the charge in combating HIV/AIDS in rural North Country communities for the past 15 years.

Rietsema, who is also the medical director for CVPH Medical Center, recently received the 2009 Linda Laubenstien Award for Excellence in HIV Clinical Care from the state Department of Health's AIDS Institute.

"When I came here 15 years ago, there was no one in the area providing the kind of care needed (for HIV patients)," Rietsema said from his CVPH office recently. "People had to travel to Burlington, Albany or Syracuse for treatment.

"It took us three, four, five years to grow to what we are today, but we provide care for 50 to 70 patients in the three-county area. That's not a huge group of people, but it's a needed service in this kind of rural community."

Rietsema credits vastly improved survival rates for HIV patients to a much stronger regimen of medications that prevent the AIDS virus from replicating and impacting the body's immune system.

"In the end, it's all about the medication," he said. "That has made all the difference in a dramatic drop in the death rate."

Science has yet to find a cure for the virus but must settle for now with controlling it, he added.

But Rietsema has played a major role in helping his patients realize the importance of taking their medications on a consistently regular basis.

Unlike drugs for such chronic conditions as high blood pressure that can continue to be effective even if a patient misses a dose here and there, the AIDS virus can quickly develop an immunity to medications if a patient is lax in taking them regularly, he explained.

"Then you have to go to new pills, and there isn't an endless supply (of HIV medications)."

Years ago, patients had to take a dozen pills or more daily to combat AIDS and its side-effects.

Today, doctors will prescribe a minimum of three medications — sometimes contained in one pill — to effectively treat the HIV infection by blocking certain sections of the virus's replication within the cell.

HIV drugs are very costly, ranging between $1,000 and $3,000 per month.

Working at the CVPH Health Center, however, Rietsema's clinic receives better reimbursement rates than a private doctor would for comparable services and can accept Medicaid and the federal AIDS Drug Assistance Program (ADAP).

Treatment also involves regular testing to ensure medications are working effectively. Rietsema sees each HIV patient every few months, the check-ups focusing on how well patients are taking their drugs and on the results of those blood tests.

Overall, Rietsema said about 70 percent of his patients consistently do well with taking their medications regularly. Helping them deal with HIV in a rural setting has also been a major focus of his health care.

"We face a different set of issues (than urban settings that treat HIV patients), not the least of which is transportation," he said.

Diana Aguglia, regional director for the AIDS Council for Northeastern New York, praises the opportunity Rietsema's clinic provides for AIDS patients in the area.

"The clinic he runs is vital to our clients," she said, acknowledging the benefit patients gain from his acceptance of AIDS and Medicaid. "He also makes personal calls to the AIDS Council to check on patients when he hasn't seen them for a while.

Many of Rietsema's patients come through the AIDS Council or are diagnosed at local health-department or Planned Parenthood offices, she added.

"He and his staff are very supportive," she said. "We hear nothing but good things about the clinic from our clients."

E-mail Jeff Meyers at: jmeyers@pressrepublican.com


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