Dr. Gallant's Video Wrap-up Of CROI 2011

[tednlou2]

First, my apologies for starting 2 threads within an hour of each other, but I thought this was important. 

I think the main headlines are:

Salvage therapy and lack of drugs in the pipeline

Dr. Gallant saying people who start HAART early at higher CD4s have good chance of basically being like someone HIV Negative

People who delay meds, because they have higher CD4 counts and low viremia may be putting themselves at risk for things like lymphoma down the road.  That hit home with me, because he talked about someone who seems to be doing great off meds for years with a CD4 around 700 and viral load around 10k may actually have more complications from year after year of viral replication and inflammation than someone who had a viral load of 1 million, but got it down quickly with meds.

http://www.thebodypro.com/content/art60726.html

[mecch]

Thanks for sharing that link.

[metekrop]

Dr. Gallant saying people who start HAART early at higher CD4s have good chance of basically being like someone HIV Negative

So may this lead us to a conclusion that a person who keep on HAART meds to the fullest and bring about to a higher CD count through time can possibly become HIV negative too?  Because normally the HAART increases some peoples CD count into a higher numbers.

[mecch]

So may this lead us to a conclusion that a person who keep on HAART meds to the fullest and bring about to a higher CD count through time can possibly become HIV negative too?  Because normally the HAART increases some peoples CD count into a higher numbers.

No. Not the implication. Current HAART does NOT promise a cure. High cd4 counts does make one become HIV-, ever. Is this clear?

[Dachshund]

High cd4 counts does make one become HIV-, ever. Is this clear?

Not really. I think you mean does not make one HIV-.

[metekrop]

Current HAART does NOT promise a cure.

Why?? The doctor said that HAART at the higher CD4 can give a person a good chance to be a negative.  Does it indicate then the promise associated with HAART to convert a person from positive to negative at some given stage.  Is it not then a cure? The doctor needs to give further explanation on this, I think.

[Ann]

Metekrop, he said that people with high CD4s can be LIKE someone who is hiv negative. He didn't way they would BE hiv negative.

What he's saying is that someone with high CD4s can be as healthy as someone who does not have hiv. But we pretty much already knew that.

Ann

[Miss Philicia]

I had a detectable viral load for probably 18 years so I expect a shitstorm of inflammatory conflama to arrive at my doorstep any day now.  And yeah, I do worry about that a little.  Nothing I could have done would have made a difference, however.

[WillyWump]

Does it indicate then the promise associated with HAART to convert a person from positive to negative at some given stage. 

I read or heard somewhere that it's believed someone on HAART and Ud could have their Reservoirs depleted after 60-80 years, thus becoming essentially HIV-. Does anyone remember that theory? Or did I dream it up?

If so I guess you could wait until you are in your 100's to become neg.

-Will

[mecch]

Sure we've heard of that theory!  I think we were just responding the current reality and the poster's misunderstanding of the language.

I liked the overall general optimistic and rather calm, clinical tone to Gallant's message.  Noted of course the warning and concern about salvage therapies, of course. 

Also very interesting the discussion of the economics of Pre-exposure Truvada in first world vs developing world.  Its so ironic that the first world wouldnt be able to take full advantage of a pre-exposure plan to reduce transmission because of the cost!  I wonder how that will shake out in the next few years between socialised medicine in Europe and for-profit or at least very mixed up situation in the states. 

Will European health authorities ok funding for truvada for all the hiv- guys who want to bareback as a lifestyle choice?