October 20, 1997
Volume 50, No. 9
Back in 1986, when Grady Hospital first opened its infectious disease clinic (IDC), the clinic's caseload was only a few hundred patients. Then, as now, the IDC was staffed by Emory physicians assigned to Grady.
But as the AIDS epidemic grew and the need for specialized treatment increased, so did the community's response. In 1993, the IDC and a number of auxiliary programs were relocated to the Ponce de Leon Center, a spacious building in Midtown.
Now Atlanta has one of the largest and most comprehensive HIV treatment facilities in the country, said Jeffrey Lennox, medical director of Grady's Infectious Disease Program and assistant professor of medicine at Emory. "It's something to be proud of because this clinic was established through the efforts of not just Emory or Grady but the people in the community," he said.
In all, the infectious disease clinic provides care for approximately 4,000 patients. Although the primary mission is treating HIV infection, about 1 percent of the patients have a tropical disease or some other chronic infection, Lennox said.
The Ponce de Leon Center houses a primary care clinic serving both men and women, and a family clinic that treats mothers along with their children. It also includes a dental clinic, a mental health clinic, a research area for clinical drug trials and an infusion area where intravenous therapies are administered on an outpatient basis.
A subspecialty clinic provides for consultations in ophthalmology, dermatology, neurology, hematology and oncology. And in the spring of 1998, the IDC will be adding a perinatal substance abuse clinic for pregnant women who are using drugs and are at risk for contracting HIV.
The Ponce de Leon Center also houses AIDS-related organizations and services, including Project Open Hand, an agency that provides meals for people with HIV infection; AID Atlanta, a case management service; and an office of the Department of Family and Children Services.
"We set it up to make it easier for people to receive their care, so they don't have to run all over town to get services," Lennox explained. "Because a lot of our people don't have transportation, we're located right on two major bus routes in a fairly central area of Midtown."
New patients to the clinic are assigned their own provider for medical services, rather than seeing someone different each time. This provider-either a physician, physician's assistant, or nurse practitioner operating under a physician's guidance-decides whether the patient needs referral to other clinics.
For social services like housing, emergency food assistance and welfare, patients see a case manager provided by AID Atlanta.
The IDC's research clinic-staffed by Emory physicians, nurses and social workers-is one of the few sites in Atlanta that conducts AIDS clinical trials. Currently the clinic is testing three- and four-drug combination therapies that include experimental drugs.
The current standard of care for people who are not in a clinical trial are various combinations of three drugs that have been approved by the Food and Drug Administration, Lennox said. These usually include a protease inhibitor.
In many cases these treatments have lead to a dramatic temporary reversal of the disease process. "We've seen people put on 30 pounds of weight," Lennox said. He said people once too weak and debilitated to get out of their wheelchairs regained their strength and began to walk again. "That is a common thing for us to see," he said.
"Unfortunately, a lot of people don't realize this is temporary," Lennox added. "We don't have a cure. What we're hoping is that many of these patients will continue to do well until we do have a cure."
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