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Innerbrat
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Not of interest. 
22nd-Oct-2007 11:39 am
earth, hhgttg
HIV Neutralisation?

A couple of non-scientists linked to this with appropriate "OMG" reactions,and I thought 'Wow, looks like a breakthrough'. Amazing scientifically breakthroughs that aren't plastered all over the headlines (or even on BBC Health) worry me. Especially as the paper in question was published in August. (And yes, I went through the BBC archives as well.)

So I went and dug out the article itself on Lancet. I have no idea how much you can see from a non-institution, so I apologise if it's poor. Then I read around. This, I have to emphasise, is the result of Googling by a palaeontologist, so don't take it as a lecture from on high or anything. Wikipedia is a good source for everything, after all.

The article discusses Combination antiretroviral therapy (cART) which has been used to fight HIV for years (At least ten of them. Probably more, but I briefly saw the year 1998 mentioned), where antiretrovirals are simply a type of drug used to inhibit retroviruses such as the Human Immunodeficiency Virus. It simply means using a number of drugs to fight HIV, so that immunity to one drug cannot evolve, thanks to simultaneous attacks by another drug.

HIV invades CD4+ cells among others. These are lymphocytes which play a vital role in the human immune system: they activate and direct the action of other immune cells, and thus are important in fighting a whole range of things.

The study in question looked at the long term effects of cART on people with HIV, specifically the CD4 count over years of cART therapy. And their conclusion? CD4 counts continue to increase with years of therapy, although the rate of increase is not as great as in later years. The implication of 'normalising' CD4 countsis only inferred from the increase, and not demonstrated.

THIS IS NOT A CURE.

It's not even new. It doesn't eliminate HIV in the blood stream, it restricts replication and evolution of resistance. It requires the patient to continue to take a cocktail of drugs for years. With all the side effects tied in with them:

The most common side effects are nausea and feeling tired. Side effects are often referred to by the grade of the effect, and the grades range from mild to moderate to severe to life-threatening. For example, it is considered a mild side effect if a person has 2-3 vomiting episodes a day. Life-threatening side effects such as extreme limitations in daily activity and hospitalisation are rare, but are still threats to some.
And let's not forget that most HIV+ people in the world simply don't have access to the drugs in question.

Don't get me wrong, it's good news. It's just not amazing breakthrough type news. And the line about allowing patients to rebuild their immune system to the same levels as the rest of the population. is speculation at best. Mind you, extra credit to Science Daily for using the phrase 'HI-virus'.

We now return you to your regularly scheduled fannish ramblings.
Opinions 
22nd-Oct-2007 10:42 am (UTC)
Aww. :(

Dammit, I want miracle cures in my life.
22nd-Oct-2007 10:53 am (UTC)
Can I please link this to my fellow LJ-medics? Because primary research and study of HIV/AIDS makes up about an eigth of our course this year (although we haven't officially started it yet) and I really like your analysis of it.
22nd-Oct-2007 10:56 am (UTC)
Of course.

You'll probably know more than me about it by the end of the term. This is what I got from the internet in an hour.
22nd-Oct-2007 11:02 am (UTC)
Thanks :)
22nd-Oct-2007 12:42 pm (UTC)
I saw that on SD.net and it looks like it's just the Triple Cocktail, which is not news (the drug companies not being dicks about said drug would be news).

I understand the current favored method is to periodically take a patient off drugs long enough so the internal environment of the body becomes more favored again to non-drug resistant viruses, which makes treatment effective again so you don't have to give huge doses. I heard this is actually very effective.
22nd-Oct-2007 12:49 pm (UTC)
Makes sense that it would be. Long term exposure to drugs can't really be a good idea. Ths study seems to think it does good keeping them on, though.
22nd-Oct-2007 04:37 pm (UTC)
...Wow, Science Daily. Way to jazz up old news.

It's possible for patients to rebuild, and be almost as good as the rest of the population. I sort-of know a guy who's "recovered." (VERY loose usage of the term.) But those cases are pretty rare. And, y'know. The whole issue of drug companies making it impossible for a lot of people to get these drugs.
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