HIV is still complicated. In the last two decades a universally lethal illness has been transformed into an infection people can live with for a relatively normal lifespan.

Research in HIV and related conditions continues to forge ahead. In We’re getting there, we provide an update on hepatitis C treatment, which is at the exciting stage HIV treatment was at in the early 1990s: we may be able to treat the vast majority of infections soon (though whether the NHS will fork out the £28,000 cost per person is another question). And one of the most exciting stories from February’s Conference on Retroviruses and Opportunistic Infections (see News in brief) was the first proof-of-concept of a gene therapy that could eventually lead to a cure for HIV.

That does not, however, mean that having HIV means everyone can pop a daily pill or two and they’ll be fine.

I was reminded of this recently when I stayed at a gay B&B. One of my fellow guests was in his 50s. He’d been diagnosed with HIV ten years ago because he’d had anal cancer. He had permanent kidney damage due to the side-effects of HIV medication and the cancer chemotherapy had knocked his immune system so badly that he’d developed AIDS-defining recurrent herpes symptoms which were very hard to live with. He was very grateful to his clinicians for the care they’d given him and the complicated decisions they’d had to make to keep him alive, but it had been a very near thing, and the same man diagnosed today would present exactly the same medical care challenges.

That’s why in this issue we’ve gone back to the clinical basics a bit. Matt Sharp covers lymphoma, another HIV-related cancer that still presents a formidable health management challenge (see HIV and lymphoma). And as part of NAM’s original, founding commitment to provide people with HIV with the information they need to make the best decisions about their health, we include David McLay’s cut-out-and-keep guide to the most commonly used medical tests (see Testing, testing, one, two, three); next time your doctor tells you everything is “fine” or “your cholesterol’s up a bit” and you’d like to know more, you can whip it out and quiz him or her on exactly what’s going on and whether to do anything about it.

One of the additional complications of HIV is how to afford it. Although we have made tremendous progress, we still live in a world where half the people who need antiretrovirals to save their lives don’t get them. As we reveal in HIV drug prescribing in London however, HIV treatment is also becoming increasingly difficult to afford in the UK. Health commissioners are having to make hard-nosed decisions about offering the most affordable regimen that doesn’t endanger health, rather than the perfect one.

In the current situation, a truly collaborative approach to treatment between patient and doctor is more important than ever, which is why we’ll keep providing the information you need. Stay well.