Mar 06 2014

Raising Shields Against HIV

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125 responses so far

125 Responses to “Raising Shields Against HIV”

  1. fergl100on 06 Mar 2014 at 8:29 am

    Yes I know full well what you mean about false hopes. I have CF and was hoping about 15 years ago that gene therapy would “cure” my lungs. It’s not happened and CF research has had lots of money in that period. AH well I’ll struggle on but it is a shame. Hope it happens soon!

  2. MikeBon 06 Mar 2014 at 9:32 am

    “Researchers … used used a zinc-finger nuclease (ZFN) to render the CCR5 gene permanently dysfunctional in the T-cells taken from the patients, and then transfused the cells (about 10 billion of them) back into the patients.”

    OMG! Doesn’t this mean the HIV patient receiving this treatment will have to be labeled a GMO???

    (Just joking … but mark my words …)

  3. evhantheinfidelon 06 Mar 2014 at 10:52 am

    Is there speculation or (even better) research as to why the zinc-finger nuclease, or even the outright mutation would work for some people and not others? I guess, is it likelier to be variations in HIV, humans, something environmental, or even something yet I haven’t guessed, if anyone has any idea at all?

  4. pmb6465on 06 Mar 2014 at 11:28 am

    The Wall Street Journal had an article about this today too….

    http://online.wsj.com/news/articles/SB10001424052702304554004579421602888753292?mod=WSJ_hpp_MIDDLENexttoWhatsNewsThird&mg=reno64-wsj

  5. Bronze Dogon 06 Mar 2014 at 1:02 pm

    OMG! Doesn’t this mean the HIV patient receiving this treatment will have to be labeled a GMO???

    I’m thinking of dialogue from X-COM: Enemy Within. You can apply “gene mods” to your soldiers that often includes giving them alien features. (In silly sci-fi fashion, of course. You want a secondary heart? Just give us three days!) At one point, Dr. Valen speaks with concern about how it will affect them once the war’s over. I’d agree long term medical issues would be a concern. On the other hand, thinking about anti-GMO rhetoric and their notions of genetic purity, I’d wonder if they’d start a campaign of discrimination against gene modded veterans. My inner comic geek wanders over to the mutant registration acts the X-Men had to deal with.

  6. pdeboeron 06 Mar 2014 at 1:21 pm

    Very cool. Maybe this will lead to a HIV shot that is very different from conventional vaccines. I hope the living without the CCR5 receptor has no ill effects though.

    Regarding the second child to be “cured”. I though HIV viral load was sometimes not detectable when undergoing antiretroviral treatment. This second child is still being treated. The first was off meds for 18 months and showed no signs of the virus? Is this a case of the media exaggerating standard affair for children born with HIV?

  7. Steven Novellaon 06 Mar 2014 at 1:57 pm

    I don’t have the details on the second case. They don’t appear to be published yet. But in the first case they used detection techniques that go beyond the standard viral load test.

    They do acknowledge that the only way to be sure is to go off of medications and follow the blood tests, but that is very risky. So it’s a catch 22.

  8. DietRichColaon 06 Mar 2014 at 4:13 pm

    Dr. Novella – Yes, you do need to balance enthusiasm with sober assessment… but on this one, it’s a real possibility you may just get to be excited and stay excited.

    My wife is a biochemist at a cancer research center, and her research largely revolves around protein engineering and gene therapy. She isn’t directly involved in the gene therapy itself — she describes her work more as developing the “toolkits” that are used to carry out the gene therapy. My knowledge of biochemistry is… lacking… but I DO recognize ZFNs because my wife talks about them all the time. The ZFNs are one type of “toolkit”.

    Apparently there are four primary platforms for gene-editing being explored for gene therapy applications. ZFNs are one (the oldest and most well-characterized), TALENs (transcription activator-like effector nucleases), homing endonucleases, and the CRISPR (clustered regularly interspaced short palindromic repeats) / Cas9 system. I included the acronym names for clarity… please don’t ask me what they actually do. There are other methods too, but she says these are the 4 big ones.

    While her lab doesn’t collaborate with the specific group you mention… this process of using these gene editing tools to modify T-cells then reintroducing the T-cells back into the body is very promising. She always comes back from conferences and meetings very excited. When I ask her to quantify for me what she really means and why she’s excited (because the real biochemistry usually goes over my head), her response is always just “one of these guys is going to do it!” (use gene therapy to cure something). And not just in the “this concept will work” but as in they are actually making it happen.

    And this method is not just limited to CCR5 and HIV. While there are groups involved with each of the different gene-editing methods working on targeting CCR5 for obvious reasons, she said this method is also viable for “arming” T-cells to combat specific cancers or other diseases too. She said if you’re interested in more on this, check out this interview with Dr. Carl June (the last author on the paper you cited):

    http://www.cancerresearch.org/our-strategy-impact/people-behind-the-progress/scientists/dr-carl-june-offers-pancreatic-cancer-patients-re

    At this point, it isn’t so much a question of IF we can do this, it’s WHO is going to do it first (which platform will work best) and get it all the way through clinical trials. It’s a very exciting time.

    Crossing my fingers that I’m not just giving everyone more false hope… but this might be one of those “5 years away” things that really truly is.

  9. hardnoseon 06 Mar 2014 at 6:58 pm

    For all we know at this time, AIDS will never be cured. I don’t see any reason to get excited about preliminary research.

    And the story of AIDS is not nearly as shining as you think. The HIV drugs are extremely toxic and cause serious side effects, especially after prolonged use.

    We really do not know how effective they are, because it is not possible to compare treated vs. untreated patients (for ethical reasons, a standard treatment can’t be withheld).

    The original AZT trials never showed any benefit after 2 years.

    We simply do not know if the benefits of ARV drugs outweigh the terrible side effects, which may include death from cancer, liver disease, heart disease, etc.

    HIV is a huge money-making industry, lots of it funded by us taxpayers.

    I am a skeptic, not an HIV denier. I really think if you want to call yourself a “skeptic,” you should reign in your ecstasy when praising the HIV industry. At least become informed about some of the dangers of the HIV drugs.

    I am not an AIDS researcher, but have followed this subject carefully for years. I believe that AIDS is a much more complicated disease than what mainstream researchers believe, and that is why it can’t be cured by anti-HIV drugs.

  10. Ekkoon 06 Mar 2014 at 7:10 pm

    @hardnose
    “I am not an AIDS researcher, but have followed this subject carefully for years. I believe that AIDS is a much more complicated disease than what mainstream researchers believe, and that is why it can’t be cured by anti-HIV drugs.”

    If you are really a skeptic, “belief” should not enter into things. How on earth can you say any of this with a straight face? What makes you think mainstream researchers are off the mark but somehow you have more insight than them?
    This isn’t a subject I know a lot about but my impression is that being HIV+ has gone from a death sentence to more like a manageable chronic disease. Where do you source these “non mainstream” opinions of yours from?

  11. grabulaon 07 Mar 2014 at 2:17 am

    @hardnose – the proof is in the pudding. We have several decades of evidence as to whether these drugs work or not. In the 80′s people were dying of AIDS. Now a days, they effectively live long and healthy lives. That doesn’t count as evidence to you? If the medication isn’t helping than what would you say is?

    Side Effects suck, but taking the medication is a choice and I’m betting the numbers indicate most people are willing to live with the side effects in order to extend their lives.

    “I am not an AIDS researcher, but have followed this subject carefully for years. I believe that AIDS is a much more complicated disease than what mainstream researchers believe, and that is why it can’t be cured by anti-HIV drugs.”

    So in one stroke you claim not to be an AIDS researcher but you know better than the AIDS researchers?

    I’m also pretty sure no one is stating HIV is being cured so much as treated currently, which is a big difference. Anything that might potentially be a cure is worth getting excited about.

  12. steve12on 07 Mar 2014 at 2:20 am

    @Hardnose

    With so many claims, links would be great

  13. Aardwarkon 07 Mar 2014 at 3:37 am

    Hardnose,

    I respect your skeptical (and non-denialist) position regarding HIV/AIDS, but have two points to make in addition to the three replies you already received (that I also perfectly agree with).

    First, you quote lack of success of treatment with AZT alone as an argument against HAART. Well, if you read carefully the available literature on antiretroviral therapy, as you say you did, then I think you must already know why AZT alone failed. The reason is that the virus quickly develops resistance to a single drug. Current treatment success only happened when three or more antiretroviral agents, with different mechanisms of action, were combined. In this way, evolution of the virus toward resistance is (in most cases) prevented, or at least significantly delayed.

    In addition (second part of the first point) it is not true that treatment effects are not verified (because you cannot have a ‘no treatment’ arm in the clinical studies). Any proposed improvement to the treatment protocol is always tested against the current protocol without this improvement. In this way, the treatment evolves in sequential steps, and that is how we got to the present protocol. It can certainly be improved, by the same strategy, in the future. And there is every possible reason to expect that it will, be our excitement great or small.

    (N.B. The treatment by genetically modified T cells, that is discussed here, is a new strategy, so it will, naturally, be tested against HAART alone – again not ‘tested against itself’ as you implied).

    The second point – profits made by drug manufacturers and earnings of medical professionals may be considered to be fair or less so (or even grossly unfair). It certainly merits serious discussion. However, this is a separate question from the one at hand – whether the treatment works. This is the very reason we advocate science-based medicine: to know what works and what does not, regardless of who is selling it and for how much.

    (And, by the way, when quoting the profits made by treating disease, one should not overlook how much of these go into research of new or improved drugs – hardly an unimportant issue.)

  14. BillyJoe7on 07 Mar 2014 at 6:12 am

    Only one stone left for me….

    HN: “For all we know at this time, AIDS will never be cured”

    We don’t know all at this time, so it’s not possible to conclude that AIDS will never be cured.

  15. SteveAon 07 Mar 2014 at 7:52 am

    This article from Sense About Science may be of interest:

    The Dallas Buyers Club and the myths of Aids activism

    http://www.senseaboutscience.org/blog.php/84/dallas-buyers-club-and-the-myths-of-aids-activism

  16. Steven Novellaon 07 Mar 2014 at 8:28 am

    Hardnose – when it is unethical to withhold standard of care you can compare treatments to each other, and you can compare to historical controls.

    In the case of HAART treatment, the historical controls are pretty dramatic – almost 100% fatal within a few years without treatment.

    On HAART patients basically have a normal life expectancy. That is a dramatic result that is undeniable. Sure, medications with fewer side effects would be nice, and we are moving in that direction. But, wow, way to focus on the negative. Have you ever spoken to anyone who is HIV positive? Do you have any idea how the average HIV positive person feels about HAART?

  17. dsdotyon 07 Mar 2014 at 8:31 am

    It’s hard to argue with your view that HIV is a scientific success story, but it does seem at odds with the traditional gay community narrative, in which homophobia and scientific infighting minimized research and funding, and hampered co-ordinated efforts amongst the people who were working on the disease. I’m curious: do you believe that narrative misunderstood what was happening in the scientific community, or that it was an accurate reflection of the early years of the epidemic, and that scientists subsequently turned the narrative around?

  18. hardnoseon 07 Mar 2014 at 9:12 am

    Steve N,

    You are confused, but most people are confused about this. The AIDS diagnosis changed since the epidemic was first noticed. Other factors have changed. It is impossible to draw conclusions about causation based on what you have said.

    Comparisons are between AZT and newer drugs — that tells us nothing about whether any of the drugs are safe or effective.

    AIDS was originally a death sentence because only very sick patients arrived at the clinics. Now all that is required is a positive HIV test and low counts of certain immune system cells. Many things besides AIDS can cause that.

    The gay lifestyle also changed since the epidemic began, and people became much more careful. AIDS might not be exactly the same disease that it once was.

    We know that HIV drugs can kill opportunistic infections (because they can kill anything), giving the illusion that they address the underlying disease. But it is very possible that killing HIV has no effect on the disease. HIV might be a causal factor (or it might not), but it does not seem to be the only cause. Even Luc Montagnier, co-discoverer of HIV, does not consider it a sufficient cause.

  19. hardnoseon 07 Mar 2014 at 9:12 am

    Also consider the long latency of HIV. Even before the new drugs, some patients lived 10 or 20 years with no symptoms. That is another confounding factor.

  20. Steven Novellaon 07 Mar 2014 at 9:43 am

    hardnose – I am sorry, but it is you who are confused.

    But let me clarify what I wrote. Once you have AIDS your life expectancy is about 3 years, after a serious infection it is about 1 year. HIV causes an acute infection followed by an average clinical latency of 10 years before progressing to AIDS.

    This is the natural history of the disease, which is well documented. It can be affected by overall health, genetics, age at onset, HIV strain, etc. but this basic natural history in untreated individuals has not significantly changed over the years.

    With HAART treatment, the clinical latency can be extended indefinitely, giving people a normal life-expectancy, and greatly reducing infectivity. Treatment with HAART extends life expectancy at any stage of the illness, but is more effective the earlier it is started and the more consistently it is used.

    HAART affects viral load, CD4 counts, and risk of opportunistic infections and other complications of HIV – such as cancer and HIV dementia.

    It is absolutely wrong to say that HAART could be entirely responsible for improved outcome without addressing the underlying illness because it treats opportunistic infections. HAART drugs are only anti-viral. Many opportunistic infections are bacterial. Some complications are directly due to HIV, or are the result of immune dysfunction but not related to infections, such as Kaposi’s sarcoma.

    HIV is the causal factor in AIDS – there is no might or might not. There may be modulating factors, but HIV causes AIDS. This is well established.

    Finally, even though we cannot randomize patients to not receive HAART, we can do observational studies comparing those who are compliant with HAART with those who are not compliant. We can also evaluate the effectiveness of HAART programs in other countries that have previously had no availability of the drugs. In every case, HAART treatment and compliance is associated with dramatically reduced mortality:
    http://cid.oxfordjournals.org/content/46/4/507.long
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2933160/
    http://www.ncbi.nlm.nih.gov/pubmed/24307741

    Frankly you are spouting HIV denialist propaganda and do not have a working knowledge of the science of HIV and AIDS. This is a complex area of medicine and unless you have medical expertise, I would not presume to think you have a better understanding than the experts.

  21. Kawarthajonon 07 Mar 2014 at 10:29 am

    @Hardnose “Comparisons are between AZT and newer drugs — that tells us nothing about whether any of the drugs are safe or effective.”

    Doesn’t the fact that patients are living normal length lives a sign that these drugs are effective??? What have changes in the gay lifestyle got to do with the progression/treatment of the disease in those who have acquired the HIV virus? Nothing, I would suspect. Besides, the vast, vast majority of those infected with HIV are not gay. Furthermore, those on long-term treatment for HIV typically lead normal lives, not bed ridden and sickly.

    As for your comment on the medications being “toxins”, everything can be a toxin given the correct dosage – even pure water. Of course they cause side effects, but most drugs do. They prevent the most serious side effects of the disease, however, – horrible illnesses followed by death. I would leave it up to those who suffer from HIV infection to determine which is more important to them.

  22. steve12on 07 Mar 2014 at 11:56 am

    @Hardnose

    In general, you make a lot of claims about facts that are highly questionable and almost never provide links.

    I’m not talking about interpretations or opinions, but facts. When you do this, you gotta back it up with something. We’re not in bar – you can easily send us links backing up the factual claims you’re making and we can hash it out from there.

  23. etatroon 07 Mar 2014 at 12:20 pm

    A sliver of HIV denialism was in HN’s first comment, saying that AIDS cannot be cured by anti-HIV drugs. He’s been rhetorically making a distinction in every comment implying that HIV is not the causative agent of AIDS. As a syndrome, AIDS is essentially prevented by ant-HIV medications. Very well documented cases (one or two large studies actually) of treatment withdrawal and modification show that when therapy stops,viral loads go up and CD4 counts go down. Those are the effective markers leading to AIDS, which is diagnosed when CD4 falls below 200 cell/mL. (There are actually different stages of HIV/AIDS and the WHO classification scheme is different than the CDC scheme). Treatments can fail if the virus acquires a resistance mutation (which is more probable if patient is non compliant), switching drugs will in most cases bring VL back down and CD4 back up. This phenomenon is extremely well documented, we know which mutations confer resistance to which drugs and in the institute that I work at, it is standard practice to get the viral genotype before prescribing.
    HN notes that the “latency” period is very long for some people, but he is misapplying the word “latent,” which has a specific meaning in virology. Latency for HIV means that the viral genome is integrated into the host cells’ genome and does not replicate by producing viral proteins and assembling virions. It can reproduce though whenever the cell itself replicates & divides. The population of latently infected cells is called the viral reservoir, which is not normally measured in the clinic, but in research studies (at my institute), patients with undetectable viral load have about 0.1% latently infected cells in the blood. I am specifying the blood because latently infected cells can also be in bone marrow and in tissues. I think what he means is lag-period between infection and immune suppression, which is highly variable, yes. But the dynamics of acute infection work almost like clockwork, with about a two week lag period followed by exponential increase in VL, at this point CD4 cells die, then circulating VL starts to go down at 4 weeks and will go down to a plateau level that is variable (with therapy, will go to undetectable in most cases by 8 weeks post initiation). All of this is so well documented (just search pubmed), that it must be huge feat of cognitive dissonance & delusion to deny.

  24. Steven Novellaon 07 Mar 2014 at 12:25 pm

    To clarify further – the term “clinical latency” is often used, as I did above, to refer specifically to the period between the acute infection and first clinical signs or symptoms of AIDS.

  25. hardnoseon 07 Mar 2014 at 12:44 pm

    Steve N,

    You did not link anything showing that AIDS patients treated with HAART live normal lives. That seems very unlikely given the toxicity of the drugs.

    I would also like to complain about the label “HIV denier” being thrown around. That’s just a tactic for discrediting anyone who finds the mainstream view unconvincing.

    From the beginning, AIDS researchers were desperate for a simple explanation, and a straightforward treatment (kill the bugs, get cured).

    That is understandable but, sadly, AIDS does not seem to be a straightforward infectious disease.

    If you really think about it, how many cures has the medical industry come up with in the past 50 years?

    We have more and better antibiotics, surgical and imaging technology. But our understanding of most diseases has been stalled for a long time.

    Some of you whole claim to be skeptics are really enthusiastic supporters of whatever the mainstream consensus happens to be.

  26. Ekkoon 07 Mar 2014 at 1:58 pm

    hardnose,
    You are demonstrating many classic examples of the Dunning-Kruger effect.

    “But our understanding of most diseases has been stalled for a long time.”
    You fail to give a single example.
    If our medical understanding of diseases – their etiology, pathology, treatments, prognosis, etc. has stalled in most cases, you should be able to give several specific examples.

    My impression is more that you don’t know what you are talking about.

  27. zorrobanditoon 07 Mar 2014 at 2:11 pm

    All very interesting, hardnose (and everyone else), but I think we’ve had enough hand and arm waving. How about some links everyone can check out?

  28. hardnoseon 07 Mar 2014 at 2:19 pm

    Ekko,

    Just think of any of the most common chronic diseases. How much progress has there been in understanding and treating MS, for example? And aside from recommending lifestyle improvements, how has the understanding of heart disease and stroke improved? How about cancer? We are hardly any better off than 50 years ago.

    What about dementia? Really nothing new or better.

    Mental illness? More and fancier drugs, but they only dull symptoms. Understanding in psychiatry has barely changed in over a century.

  29. steve12on 07 Mar 2014 at 2:36 pm

    Hardnose just isn’t having it. He’s just gonna talk shit and back none of it up. Because it’s SO HARD to paste links.

    “Understanding in psychiatry has barely changed in over a century.”

    This is just ridiculous. Serious mental illness is not cured. But to say that our understanding of the genetics and neural substrate substrate underlying mental illness has not changed in the past 100 years… that is (pardon the pun) insane.

    If you wanna claim this was a bit of hyperbole, no worries. But if you’re serious, you need to demonstrate some SERIOUS knowledge floating around 100 years ago!

  30. Hosson 07 Mar 2014 at 2:55 pm

    hardnose

    Several people have been asking you for something besides your(painfully ignorant) opinion. Can you stop asserting and start providing evidence? Your word alone is not good enough…no ones is.

    Or do you have nothing besides a narrative, which you base all your claims off of, that with 10 minutes of googling is demonstrably false.

    Do you not know how to do research?

  31. Ekkoon 07 Mar 2014 at 3:08 pm

    hardnose,
    MS is not a common chronic disease for starters. Heart disease, diabetes, cancer, arthritis, these are common ones. But still, there is a massive amount of research that has been done to broaden understanding of genetic and environmental causative factors of MS as well a lot of current research into potential treatments.
    When you say about cancer that “we are hardly any better off than 50 years ago” – what do you mean? What kind of cancer? What age groups? Hardly better off in our understanding of the cause and progression? The treatments? For example, survival rates for cases of childhood cancers have vastly improved across a wide variety of types. Treatments for previously untreatable forms of childhood cancers and with less toxicity have come about thanks to research.
    http://onlinelibrary.wiley.com/doi/10.3322/caac.21219/full

    “how has the understanding of heart disease and stroke improved?”
    http://brain.ubc.ca/research/stroke/
    http://www.heartandstroke.com/site/c.ikIQLcMWJtE/b.8968559/k.DE2D/2014_Report_on_health__Creating_Survivors.htm

    Again, I don’t think you’ve ever really bothered to look into this much and are just being hardnosed about wanting to only see the negative.

  32. Solenoidon 07 Mar 2014 at 3:08 pm

    Hardnose:

    “How much progress has there been in understanding and treating MS, for example?”

    Please direct your attention to AVONEX by Biogen Idec (http://www.biogenidec.com/therapies.aspx?ID=5489) or AUBAGIO by Genzyme (http://www.genzyme.com/Company/Business-Units/Multiple%20Sclerosis.aspx), or LEMTRADA, also by Genzyme (currently fighting its way through the FDA)(http://news.genzyme.com/press-release/genzyme-receives-complete-response-letter-fda-lemtrada-alemtuzumab-application)

    “How about cancer?”

    How about GLEEVEC (www.gleevec.com/) and VELCADE (http://www.millennium.com/ourMedicines/Velcade.aspx)?

    “any of the most common chronic diseases”

    Autoimmune diseases – Infliximab, Adalimumab, and Etanercept.
    Diabetes – Lantus
    Influenza – Oseltamivir

    Need I go on?

  33. Steven Novellaon 07 Mar 2014 at 4:13 pm

    hardnose – you are making a lot of bold claims without evidence. These things may seem “obvious” to you, but that is likely just confirmation bias.

    I never said that patients with HIV live normal lives. I said they have normal life expectancy.

    Your examples of our lack of progress are based entirely on your own personal ignorance. MS, for example, was a terrible example to use. 50 years ago we knew very little about the disease. The only treatment available was steroids for acute exacerbations.

    Since then our understanding of immunology in general, and the immunology of MS, has exploded. We now have a far more detailed map of the immune system.

    We also have developed a list of specific immune modulating drugs that actually alter the course of the disease. – Avonex, Betaseron, Copaxone, Aubagio, Extavia, Gilenya, Rebif, Novantrone, Tecfidera and Tysabri. None of these drugs were available 20 years ago, let alone 50. The management of MS has been transformed in the last 50 years.

    Cancer is another terrible example (well, all your examples are terrible). 5 year survival in 1975 was 50%, now it is 68% and 81% for childhood cancers (all cases, all cancers). If you think the experience of a cancer sufferer in 1964 is similar to that of someone in 2014, then you clearly have no idea what you are talking about. Not only has survival steadily increased, but surgical procedures are much more specific and less radical, and chemotherapy (although, of course, remains highly toxic) is far less toxic than the older drugs.

    Your claims are so disconnected from reality that, again, the only reasonable conclusion is to seriously call into question your sources. It is as if you are reading anti-scientific propaganda and believing it without question – even though the internet now puts the actual facts at your finger tips. It really is quite ironic that you are trying to grab the “skeptical” high ground while spouting such propaganda.

  34. BillyJoe7on 07 Mar 2014 at 4:20 pm

    HardNose,

    Regarding denialism.

    There is the consensus view of specialists working in their area of expertise and based on all of the accumulated evidence in that area of expertise. And then there is your opinion based on your reading of non-scientists and the scientific fringe dwellers. This means, by definition, that you are an AIDS denier. Furthermore, you are in denial of your denialism. That is a pretty big hole you’ve fallen into. I wonder if you’ll ever be able to pull yourself out.

    I suggest you keep reading this blog and the science based medicine blog.
    Maybe you’ll eventually get a sense of why what you’ve been reading up till now is total rubbish.

  35. zorrobanditoon 07 Mar 2014 at 5:09 pm

    “I never said that patients with HIV live normal lives. I said they have normal life expectancy. ”

    First, do we really know this? Has it been long enough yet for these human beings, some of whom were quite young when they were infected, to live out their “normal life expectancy”? I don’t know when exactly the current drugs were developed, but it was considerably more recently than, say, 70 years ago, the “normal” life expectancy of a baby born in this country. One hopes, of course, that this statement about life expectancy is true, but I don’t see how we could know that yet.

    Second, I was hoping that hardnose would post some links at least about the side effects of the current medications, since he seems determined to take a dark view. There may not be any for all I know, but I think I remember hearing that there are some, and that some of these can be quite serious.

    This is not at all to diminish the remarkable achievements in this area which I have seen in my lifetime. I was practicing law in San Francisco in the 1980′s when an AIDS diagnosis was a death sentence (often swiftly carried out), and when very many of my clients died of the disease. There are many horrible stories from that time, as well as many stories of heroism. All the gains we have made should be viewed against that background!

  36. etatroon 07 Mar 2014 at 8:10 pm

    Sorry I missed the “clinical latency” term, for some reason, I always use “lag,” and reserve “latency” for it’s virology meaning. For those demanding links, there are dozens of life expectancy publications out there on HIV infection. One is at pubmed.gov/23221765. It is a review summarizing several cohort studies. From the paper, those published 1980-2009, without treatment life expectancy was 10 years after seroconversion, but depends on age at seroconversion. Studies from 2010-2013. Estimates range from 68-75 years assuming 30 yr at diagnosis and good adherence. Another, assumed diagnosis at age 20, diagnosed between 1996-1999 estimated 50 yr, diagnosed between 2006-2008 estimated 65.8 yr. Another one pubmed.gov/23287403.

    The side effects can be viewed by looking at the package inserts for any medication, which you should easily be able to google. Don’t turn this into a LMGTFY game. Some of the earlier gen drugs had metabolic side effects causing fat redistribution about the torso. The combination used for high dose post exposure prophylaxis caused eye-yellowing in some people. Miraviroc, a CCR5 inhibitor caused dizziness and fatigue in some people. The big concern w HAART medications is drug interactions, they cause increased half life of some medications if they share a common metabolic pathway. Which is why an infectious disease specialist who focuses on HIV should be consulted before someone on HAART starts new drugs for any reason. The Wikipedia entries on cytochrome P450 enzymes explain the mechanisms pretty well.

    Regarding the righteous indignation at being labeled an HIV denier, if you deny that HIV causes AIDS, you are by definition an HIV denier. (Not AIDS denier like you said). Aidstruth.org is a site that two Johns Hopkins profs put together on their spare time which compiles some resources on the history & effects of HIV denialism. I am a researcher on HIV associated neurocognitive disorders and HIV interactions with drugs of abuse.

  37. hardnoseon 07 Mar 2014 at 11:33 pm

    “Cancer is another terrible example (well, all your examples are terrible). 5 year survival in 1975 was 50%, now it is 68%”

    Lead-time bias and over-diagnosis can account for a lot of the supposed improvement.

  38. hardnoseon 07 Mar 2014 at 11:49 pm

    “I was hoping that hardnose would post some links at least about the side effects of the current medications, since he seems determined to take a dark view. There may not be any for all I know, but I think I remember hearing that there are some, and that some of these can be quite serious.”

    The drugs are extremely toxic, and they do not only target HIV. All cells of the body are affected. The principle is similar to chemotherapy for cancer — use toxic substances and hope they will kill the cancer cells before damaging normal cells. Except cancer drugs are taken only temporarily, while HAART must be taken for life.

    Advocates will tell you HAART is less toxic than AZT, but that is not saying much.

    The HAART side effects that HIV patients often suffer from are sometimes called “HIV related” diseases. This is to obscure the fact that they result from the treatment, not from HIV.

    In general, HAART results in premature aging and causes many of the diseases associated with advanced age.

    Of course, it is easy to blame HIV, instead of HAART, for this, if you are determined to continue selling HAART.

  39. hardnoseon 08 Mar 2014 at 12:02 am

    “Maybe you’ll eventually get a sense of why what you’ve been reading up till now is total rubbish.”

    I spent a lot of time trying to find out the truth about HIV and AIDS. I read the extremes of both sides and found that both were irrational. I do not agree with the HIV deniers.

    But I also found that the original research supporting the HIV hypothesis was very weak, and that all subsequent research rested on the original research. When I say the “HIV hypothesis” I mean the idea that AIDS is caused by a bug, the HIV, and lives are saved by zapping the bug with toxic substances. It is the infectious disease model, which has worked so well for bacterial infections.

    I think the miracles of HAART are mostly an illusion. HIV advocates always mention the early days of the AIDS epidemic when gay men were dying in droves. Then there was a dramatic change, and many patients diagnosed with AIDS were able to survive.

    Various things happened at that time, and one was the discovery of HIV and methods for treating the infection. HIV advocates always assume that the HIV treatments are what made the difference. They don’t think about all the other things that also changed, the confounding factors.

    For example, many more people were diagnosed with HIV AIDS. They did not necessarily all have the same disease that had been killing gay men.

    The story is a typical example of something extremely complicated that people desperately want to believe is simple. In addition, there are intense marketing campaigns devoted to selling HAART all over the world. Big piles of money being made from this.

    I can’t just post a couple of links to explain the massive confusion. I had to do a lot of serious searching and careful reading. Trudging through all that marketing BS was not easy. And yes, supposedly scientific studies can be marketing BS. If you don’t know that, you should not call yourself a skeptic.

  40. BillyJoe7on 08 Mar 2014 at 1:34 am

    HardNose,

    All you have done here is give your own opinion about what you may or may not have read (and understood) about HIV/AIDS/