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Author Topic: Early Aging -- New York magazine article  (Read 56043 times)

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Offline Assurbanipal

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Early Aging -- New York magazine article
« on: November 02, 2009, 01:30:21 pm »
Powerful discussion of medical problems affecting people with HIV as they hit their 40's and 50's in the current issue of New York magazine.   The article (but not the picture captions) tries to tease apart the issues related to aging vs. duration on medications and other factors.


Another Kind of AIDS Crisis
A striking number of HIV patients are living longer but getting older faster—showing early signs of dementia and bone weakness usually seen in the elderly.


...

But in the last year or so, doctors have been troubled by the emergence of a new kind of AIDS story. Take the case of James L., 46. After testing positive in 2001, he went on a drug cocktail and life returned to normal with little effort. His exercise regime only intensified. He even went back to school for a master’s degree. At work, he rose to a six-figure position at a telecommunications firm, and his personal life flourished. He was, he told me, “a regular gay male.”

Then, halfway through a screening of the film Syriana in his local cinema, he had a disturbing revelation. “He sat through about half the movie before he realized suddenly that he had seen the same movie two weeks earlier,” says Simpson. Indeed, James ultimately pieced together evidence suggesting he’d seen the film on three separate occasions. The same problem haunted him at work. Where he had once earned praise for his organizational skills, he now drew warnings. He seemed incapable of recalling recent events with any reliability. “It’s an Alzheimer’s-like state,” he explains. Earlier this year, Simpson diagnosed him with HIV-associated cognitive motor disorder.

...

Some fifteen years into the era of protease inhibitors and drug cocktails, doctors are realizing that the miracles the drugs promised are not necessarily a lasting solution to the disease. Most news accounts today call HIV a chronic, manageable disease. But patients who contracted the virus just a few years back are showing signs of what’s being called premature or accelerated aging. Early senility turns out to be an increasingly common problem, though not nearly as extreme as James’s in every case. One large-scale multi-city study released its latest findings this summer that over half of the HIV-positive population is suffering some form of cognitive impairment. Doctors are also reporting a constellation of ailments in middle-aged patients that are more typically seen at geriatric practices, in patients 80 and older. They range from bone loss to organ failure to arthritis. Making matters worse, HIV patients are registering higher rates of insulin resistance and cholesterol imbalances, and they suffer elevated rates of melanoma and kidney cancers and seven times the rate of other non-HIV-related cancers.


http://nymag.com/health/features/61740/
5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%
2014 VL UD - 48
2015 VL 130 Moved to Triumeq

Offline GSOgymrat

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Re: Early Aging -- New York magazine article
« Reply #1 on: November 02, 2009, 02:41:24 pm »
Very interesting. Thanks for posting it.

Offline Miss Philicia

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Re: Early Aging -- New York magazine article
« Reply #2 on: November 02, 2009, 02:49:09 pm »
Oh wow.  One of the guys in those pictures is in my local support group and he'd not mentioned this when I saw him just a few weeks ago.  Interesting.  I'm also skeptical about the age he listed but I'll let that one go.
« Last Edit: November 02, 2009, 02:51:00 pm by Miss Philicia »
"I’ve slept with enough men to know that I’m not gay"

Offline mecch

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Re: Early Aging -- New York magazine article
« Reply #3 on: November 02, 2009, 06:05:07 pm »
Yes. And no.
And does the article mention other lifestyle factors in that gay man's life?
This kind of alarmism makes me think of the multi drug-resistant fast progression to AIDS HIV strain a few years back.  Which was all about many things except multi-resistant HIV
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline GNYC09

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Re: Early Aging -- New York magazine article
« Reply #4 on: November 02, 2009, 06:10:14 pm »
I tend to agree with Mecch - this article seems more alarmist than anything else.  It's an interesting article but some of the problems they point out--like lipo--aren't examples of "advanced aging."  Also, just to be superficial for a moment, a lot of the folks pictured look younger than their age. 

Offline Miss Philicia

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Re: Early Aging -- New York magazine article
« Reply #5 on: November 02, 2009, 06:17:36 pm »
I'll be sure and let my 52 year old LTS friend that just had his second heart attack in 10 months that he's being alarmist about the contribution of 20 years of HIV medication on his body.
"I’ve slept with enough men to know that I’m not gay"

Offline mecch

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Re: Early Aging -- New York magazine article
« Reply #6 on: November 02, 2009, 06:30:21 pm »
Noone denies that. But the poster child of the article started HAART in 2001. And no mention of his numbers or time of infection.
My point is that HIV AIDS is incredible diverse so lets just say so, rather than inventing a "New AIDS Crisis".  This article is about LTS.  Just spell it out.  Its not going to help in a push to test all of the Bronx or Washington DC to be fear mongering about a set of the HIV population and its experiences.
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline Miss Philicia

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Re: Early Aging -- New York magazine article
« Reply #7 on: November 02, 2009, 06:45:32 pm »
Sure, if you don't plan on ever being a long term survivor yourself then I guess you have nothing to worry about as regards the subjects raised in this article. 
"I’ve slept with enough men to know that I’m not gay"

Offline next2u

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Re: Early Aging -- New York magazine article
« Reply #8 on: November 02, 2009, 07:12:00 pm »
dude, my memory is on a fast track down the drain. i try not worry about it but i am reminded on a daily basis that something's not the way it was...
midapr07 - seroconversion
sept07 - tested poz
oct07 cd4 1013; vl 13,900; cd4% 41
feb08 cd4  694;  vl 16,160; cd4% 50.1
may08 cd4 546; vl 91,480; cd4% 32
aug08 cd4 576; vl 48,190; cd4% 40.7
dec08 cd4 559; vl 63,020; cd4% 29.4
feb09 cd4 464; vl 11,000; cd4% 26
may09 cd4 544; vl 29,710; cd4% 27.2
oct09 cd4 ...; vl 23,350; cd4% 31.6
mar10 cd4 408; vl 59,050; cd4% 31.4
aug10 cd4 328; vl 80,000; cd4% 19.3 STARTED ATRIPLA
oct10 cd4 423; vl 410 ;); cd4% 30.2
jun11 cd4 439; vl <20 ;); cd4% 33.8 <-Undetectable!
mar12 cd4 695; vl ud; cd4% 38.6
jan13 cd4 738; vl ud; cd4% 36.8
aug13 cd4 930; vl ud; cd4% 44.3
jan14 cd4 813; vl ud; cd4% 42.8
may14 cd4 783; vl *; cd4%43.5
sept14 cd4 990; vl ud; cd4% *
jun15 cd4 1152; vl ud; cd4% *
july15 - STRIBILD
oct15 cd4 583; vl 146; cd4% 42
mar16 cd4 860; vl 20; 44

Offline Ann

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Re: Early Aging -- New York magazine article
« Reply #9 on: November 02, 2009, 07:14:30 pm »
Philly, I was just about to say the same thing in response to Mecch. I have to wonder how he'll be feeling 20 years down the line - or if he's planning on leaving this veil of tears in another year or two. ::) The meds today are better, sure, but we still don't know what their effects will be after years of use. We do know that years of having hiv, medicated or not, plays havoc with the body. Scaremongering? Alarmist? How about realistic?

Ann
Condoms are a girl's best friend

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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline next2u

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Re: Early Aging -- New York magazine article
« Reply #10 on: November 02, 2009, 07:18:45 pm »
that video was depressing/disturbing
midapr07 - seroconversion
sept07 - tested poz
oct07 cd4 1013; vl 13,900; cd4% 41
feb08 cd4  694;  vl 16,160; cd4% 50.1
may08 cd4 546; vl 91,480; cd4% 32
aug08 cd4 576; vl 48,190; cd4% 40.7
dec08 cd4 559; vl 63,020; cd4% 29.4
feb09 cd4 464; vl 11,000; cd4% 26
may09 cd4 544; vl 29,710; cd4% 27.2
oct09 cd4 ...; vl 23,350; cd4% 31.6
mar10 cd4 408; vl 59,050; cd4% 31.4
aug10 cd4 328; vl 80,000; cd4% 19.3 STARTED ATRIPLA
oct10 cd4 423; vl 410 ;); cd4% 30.2
jun11 cd4 439; vl <20 ;); cd4% 33.8 <-Undetectable!
mar12 cd4 695; vl ud; cd4% 38.6
jan13 cd4 738; vl ud; cd4% 36.8
aug13 cd4 930; vl ud; cd4% 44.3
jan14 cd4 813; vl ud; cd4% 42.8
may14 cd4 783; vl *; cd4%43.5
sept14 cd4 990; vl ud; cd4% *
jun15 cd4 1152; vl ud; cd4% *
july15 - STRIBILD
oct15 cd4 583; vl 146; cd4% 42
mar16 cd4 860; vl 20; 44

Offline next2u

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Re: Early Aging -- New York magazine article
« Reply #11 on: November 02, 2009, 07:21:50 pm »
realistic?

do all the old schoolers have something else because of the meds? the majority of my old poz queens have gone through some shit but they came out on top. and there is a list of ailments they can run down when required.

fuck, i definitely didn't need to see that today. ignorance im down for some denial/ignorant bliss right about now. 
midapr07 - seroconversion
sept07 - tested poz
oct07 cd4 1013; vl 13,900; cd4% 41
feb08 cd4  694;  vl 16,160; cd4% 50.1
may08 cd4 546; vl 91,480; cd4% 32
aug08 cd4 576; vl 48,190; cd4% 40.7
dec08 cd4 559; vl 63,020; cd4% 29.4
feb09 cd4 464; vl 11,000; cd4% 26
may09 cd4 544; vl 29,710; cd4% 27.2
oct09 cd4 ...; vl 23,350; cd4% 31.6
mar10 cd4 408; vl 59,050; cd4% 31.4
aug10 cd4 328; vl 80,000; cd4% 19.3 STARTED ATRIPLA
oct10 cd4 423; vl 410 ;); cd4% 30.2
jun11 cd4 439; vl <20 ;); cd4% 33.8 <-Undetectable!
mar12 cd4 695; vl ud; cd4% 38.6
jan13 cd4 738; vl ud; cd4% 36.8
aug13 cd4 930; vl ud; cd4% 44.3
jan14 cd4 813; vl ud; cd4% 42.8
may14 cd4 783; vl *; cd4%43.5
sept14 cd4 990; vl ud; cd4% *
jun15 cd4 1152; vl ud; cd4% *
july15 - STRIBILD
oct15 cd4 583; vl 146; cd4% 42
mar16 cd4 860; vl 20; 44

Offline Ann

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Re: Early Aging -- New York magazine article
« Reply #12 on: November 02, 2009, 07:50:25 pm »
Next, did you not hear the guy who said (and I'm paraphrasing) that doctors just don't know how much of the ailments and apparently accelerated ageing is down to hiv and how much of it is down to the meds? I'm willing to bet it's a combination of the two. I've been poz for twleve and a half years, no meds, and the longer I'm poz, the more I see changes that can't all be down to the natural ageing process. In fact, I'm going to be talking to my doc about this very thing tomorrow.

We have to remember that the people in this article and video have been poz for twenty-odd years. It's bound to take a toll, regardless of what meds one has taken or not taken. After all, the meds don't totally eliminate the virus, they just keep it down to a dull roar. It's still there though, doing damage. It is what it is, you know? I'm just thankful I'm here now. I try to live in the moment as much as I can and I find it's a great place to be. Why worry about the future when it hasn't happened yet and why worry about the past when it's over and done with?

Be here now. (but look up to the future now and then so you don't stumble into too many potholes!) ;D

Ann
Condoms are a girl's best friend

Condom and Lube Info  

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline bocker3

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Re: Early Aging -- New York magazine article
« Reply #13 on: November 02, 2009, 08:05:23 pm »
I try to live in the moment as much as I can and I find it's a great place to be. Why worry about the future when it hasn't happened yet and why worry about the past when it's over and done with?

Be here now. (but look up to the future now and then so you don't stumble into too many potholes!) ;D

Ann -

Words to live by and worth repeating.

You know, many years ago, as I started my sobriety, a very wise man told me the following (due to my struggle with guilt over the past and constant worry about the future):

"If you keep one foot planted in yesterday and your other footed planted in tomorrow, you end up pissing all over today."

Not sure why this has stuck so firmly in my head after 20 years, but it has helped me get over so much unnecessary worry and guilt -- including around my HIV.

Of course, this doesn't mean that you stick your head in the sand and ignore things.  Looking ahead is very good, it's projecting the outcome of the future that is wasteful.

Mike

Offline Assurbanipal

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Re: Early Aging -- New York magazine article
« Reply #14 on: November 02, 2009, 09:38:11 pm »
Noone denies that. But the poster child of the article started HAART in 2001. And no mention of his numbers or time of infection.
My point is that HIV AIDS is incredible diverse so lets just say so, rather than inventing a "New AIDS Crisis".  This article is about LTS.  Just spell it out.  Its not going to help in a push to test all of the Bronx or Washington DC to be fear mongering about a set of the HIV population and its experiences.

Mecch
The article is not solely about LTS but rather about the interaction of HIV, aging and the events that people lived through.  Teasing these issues apart is difficult to do, but likely important to each of us personally, whether or not we are long term survivors.

The first person in the story was diagnosed in 2001, not decades ago. 

And... bringing it to the personal level ... let me say that I identified with aspects of this story directly.  After all, I was diagnosed in 2006, infected for perhaps a decade or so, yet according to my DEXA scan results have the spinal bone density of the average 95 year old woman.  I'm glad I found out by breaking a wrist (like one of the people in the story) instead of my spine, skull or hip.



Lastly, let me say something to those of you who have characterized this article as alarmist.

  Granted the article does not do a perfect job of separating out what is due to age, to duration of HIV infection, to the stress of surviving a plague that killed friends and lovers, to stigma, to early overdosing of AZT, etc.  Much of that is work yet to be done on the scientific front. 

  But if you think that you have no greater risk of death and illness you are living in a dream world.  Things are much better than they were.  People who are diagnosed and treated soon after infection can have near normal life expectancy.

Yet there is NO study that shows a fully normal life expectancy, NO study that shows normal morbidity.

  Zero. 

Doctors who suggest that everything will be normal base that suggestion on hope.  Hope that medicine will continue to improve.  Hope is not science.

Hope is important to all of us.  It certainly not realistic to assume that the life chances of someone diagnosed today are as bad as they were in the past.  But if you want to live a long and healthy life, managing the risks to your health based on a realistic view of the current science is likely to be a better strategy.

A

5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%
2014 VL UD - 48
2015 VL 130 Moved to Triumeq

Offline Nestor

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Re: Early Aging -- New York magazine article
« Reply #15 on: November 02, 2009, 10:22:51 pm »
The article says:

"In a dramatic move last week, the National Institute of Allergy and Infectious Diseases upped the ante even further by announcing a massive new plan to test virtually every single adult in the Bronx and the District of Columbia—homes to some of the highest rates of infection in the country—and put everybody who tests positive on anti-HIV drugs, whether they have depleted T-cell counts or not."

Are they planning to do this testing and putting people on drugs with or without their consent?  That's sort of what it sounds like.....
Summer 2004--became HIV+
Dec. 2005--found out

Date          CD4    %       VL
Jan. '06    725    25      9,097
Nov. '06    671    34     52,202
Apr. '07    553    30      24,270
Sept. '07  685    27       4,849
Jan. '08    825    29       4,749
Mar. '08    751    30     16,026
Aug. '08    653    30       3,108
Oct. '08     819    28     10,046
Jan '09      547    31     13,000
May '09     645   25        6,478
Aug. '09    688   30      19,571
Nov. '09     641    27       9,598
Feb. '10     638    27       4,480
May '10      687      9    799,000 (CMV)
July '10      600     21      31,000
Nov '10      682     24     15,000
June '11     563    23     210,000 (blasto)
July  '11      530    22      39,000
Aug '11      677     22      21,000
Sept. '12    747     15      14,000

Offline skeebo1969

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Re: Early Aging -- New York magazine article
« Reply #16 on: November 02, 2009, 10:52:26 pm »


   In my own experience I would have to side with the article.  I'm only 40 years of age and was relatively always in good shape.  Since becoming positive I have seen many changes in myself that can be attributed to the virus and/or medications. 

   Probably the one thing I dread losing is the ability to just enjoy life...  I guess that entails a lot though.
I despise the song Love is in the Air, you should too.

Offline Miss Philicia

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Re: Early Aging -- New York magazine article
« Reply #17 on: November 02, 2009, 11:50:06 pm »
The article says:

"In a dramatic move last week, the National Institute of Allergy and Infectious Diseases upped the ante even further by announcing a massive new plan to test virtually every single adult in the Bronx and the District of Columbia—homes to some of the highest rates of infection in the country—and put everybody who tests positive on anti-HIV drugs, whether they have depleted T-cell counts or not."

Are they planning to do this testing and putting people on drugs with or without their consent?  That's sort of what it sounds like.....

Oh please -- like they're going to get all those uppity white folks in those pricey Georgetown homes to line up for HIV tests and baggies of Norvir.
"I’ve slept with enough men to know that I’m not gay"

Offline edfu

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Re: Early Aging -- New York magazine article
« Reply #18 on: November 03, 2009, 12:41:38 am »
If you're a long-term survivor and wish to comment on this article but do not wish to encounter or encourage the negative comments from those who are not experiencing the effects described in the article, I've also posted the article in the "Long-Term Survivors" forum, where only long-term survivors should be posting: 

http://forums.poz.com/index.php?topic=29712.0

I don't know how many of you know of, or know, the indefatigable Jules Levin, but the take-away quote from the article for me is his: 

"Aging is the No. 1 problem in HIV today."
"No one will ever be free so long as there are pestilences."--Albert Camus, "The Plague"

"Mankind can never be free until the last brick in the last church falls on the head of the last priest."--Voltaire

Offline elf

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Re: Early Aging -- New York magazine article
« Reply #19 on: November 03, 2009, 01:20:38 am »
Some things can be prevented: dementia by constant learning, bone density loss by taking calcium supplements...

 :-\ But I'm scared of cancer and heart attack... :-\

Offline MitchMiller

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Re: Early Aging -- New York magazine article
« Reply #20 on: November 03, 2009, 02:31:00 am »
I didn't read the article, but I do believe the meds have long-term consequences.  For that reason, anyone on meds should be taking steps to minimize their risk to heart attack (diet, exercise), cancer (diet, exercise, sunscreens), bone loss (diet, weight resistance training), dementia (diet, cardio).
I'm a believer that Sustiva is behind some of the memory loss so many complain about.  Nearly half of all HIV'ers in the first world take Sustiva.  Who knows the long term consequences of this drug on the brain.  It's like taking 1/4 hit of LSD every night... can't be good for you.

Offline mecch

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Re: Early Aging -- New York magazine article
« Reply #21 on: November 03, 2009, 05:04:36 am »
The first person in the story was diagnosed in 2001, not decades ago.  

That is exactly the point I raised. Tested positive 2001.  But it is not reported how long he was infected and since he went right on drugs in 2001 we can assume for some time.

The article mentions recently infected people once or twice, but gives NO details about our experiences.

"But patients who contracted the virus just a few years back are showing signs of what's being called premature or accelerated aging."  - No details here.

Its an informative article.  I'm just observing that it is about LTS.  And it tries to cover too much - because it discusses the Bronx and DC plans.  And there are two rationales working on those:  1) treatment is prevention and 2) moving back to direct treatment at any stage of diagnosis.  

So I join with the "retards" commenting in the New York comments section - if you want to make a persuasive case for people to be routinely tested, and indeed for an entire population to be tested and treated, then tell the whole story.  I join the retarded commentor and suggest the "happy outcome" "normal life" narrative would be more productive.

Which is not to say this article lies.  Or that these experiences are not true, for these people.

Also, if you read just one expert quoted in the article, you'll see what I'm getting at:

"But Morgello is investigating something that's both more surprising and less so: The inflammation might be caused as much by the patient’s emotional and psychiatric burden as the virus’s pathological course. “We have screamingly high rates of major depressive disorders, substance abuse and dependency, and post-traumatic-stress disorder,” she says of the Brain Bank donors. “About 40 percent of our patients have major depressive disorders when they come to the study. Substance abuse and dependency, that’s a continually moving target, but when we run urine toxicologies, about 30 percent contain illicit substances,” she says. These multiple “insults to the brain” are enough to cause the entire upswing in dementias, she says. But she admits she’s only speculating. “I wouldn’t even say we have 50 percent of the answer here,” she says."

I see a continuous and regrettable inconsistency in this forum.  People are told that the prognosis is pretty damn good if an infection is caught early and treated at proper time.  I'm willing to bet most of the countries willing to shell out for the meds will be offerring treatment to everyone regardless of stage of infection. As I have said, in Geneva, ALL diagnosed people are routinely offerred treatment. Doesn't matter if it is 1 month or 10 years.

If you don't want to include all the stories of all the experiences of people living with HIV, fine, but no reason to call some a retard, me or anyone else who has received quite a different prognosis from doctors than the people reported in the New York article.  Their experience is TRUE.  No one denies. But it is not the only experience, and time will tell.


  

« Last Edit: November 03, 2009, 05:08:47 am by mecch »
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline Assurbanipal

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Re: Early Aging -- New York magazine article
« Reply #22 on: November 03, 2009, 07:01:57 am »
Some things can be prevented: dementia by constant learning, bone density loss by taking calcium supplements...


It would be interesting to see some studies that show this in HIV-infected individuals. 

For bone loss, everything I have seen fingers HIV, testosterone and vitamin D levels -- you can take all the calcium you like but if you don't have enough vitamin D in your blood you will not absorb it and will merely have increased the amount of calcium in your piss. 

And as far as dementia goes it would appear unlikely that the guy in the article who had a career in scientific research and went back to grad school had given up on continuous learning...

That's not to suggest you give up hope on these issues.  We live in a time of great hope for continually improving treatment.  Instead it is suggesting that instead of self diagnosis and self treatment you monitor these issues with a doctor.



5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%
2014 VL UD - 48
2015 VL 130 Moved to Triumeq

Offline Nestor

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Re: Early Aging -- New York magazine article
« Reply #23 on: November 03, 2009, 08:15:30 am »

"Some things can be prevented: dementia by constant learning..."

I would love to believe that, but to be honest that article terrified me for a very specific reason: the two examples it gave of people who succumbed to severe dementia were mentally active up to the moment of sudden collapse.  James L. had gotten a master's degree some time after 2001 and then a presumably demanding job; Donald was in law school and three weeks away from his degree.  Surely they were "constantly learning"?  And they don't appear to have been abusing drugs, or massively depressed, which are the things to which Dr. Margello attributed a lot of the dementia. 

For me, the most important new information in the whole article is the following: 

"most people who showed signs of dementia while alive do not have evidence of HIV in their autopsied brain. What they do have in common, she says, is evidence of persistent inflammation, which alone could account for the cognitive damage....The inflammation might be caused as much by the patient’s emotional and psychiatric burden as the virus’s pathological course."

In other words, perhaps the single most important thing I or anyone with HIV could be doing right now is reading up on ways to fight "inflammation"?  I also see different foods and supplements praised for "anti-inflammatory" properties, and never really knowing what that meant I ignored it; now I'll pay attention.



Summer 2004--became HIV+
Dec. 2005--found out

Date          CD4    %       VL
Jan. '06    725    25      9,097
Nov. '06    671    34     52,202
Apr. '07    553    30      24,270
Sept. '07  685    27       4,849
Jan. '08    825    29       4,749
Mar. '08    751    30     16,026
Aug. '08    653    30       3,108
Oct. '08     819    28     10,046
Jan '09      547    31     13,000
May '09     645   25        6,478
Aug. '09    688   30      19,571
Nov. '09     641    27       9,598
Feb. '10     638    27       4,480
May '10      687      9    799,000 (CMV)
July '10      600     21      31,000
Nov '10      682     24     15,000
June '11     563    23     210,000 (blasto)
July  '11      530    22      39,000
Aug '11      677     22      21,000
Sept. '12    747     15      14,000

Offline mecch

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Re: Early Aging -- New York magazine article
« Reply #24 on: November 03, 2009, 08:36:26 am »
The test of a first-rate intelligence is the ability to hold two opposed ideas in mind at the same time and still retain the ability to function. --F. Scott Fitzgerald

“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline Ann

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Re: Early Aging -- New York magazine article
« Reply #25 on: November 03, 2009, 09:01:15 am »

I see a continuous and regrettable inconsistency in this forum.  People are told that the prognosis is pretty damn good if an infection is caught early and treated at proper time.  I'm willing to bet most of the countries willing to shell out for the meds will be offerring treatment to everyone regardless of stage of infection. As I have said, in Geneva, ALL diagnosed people are routinely offerred treatment. Doesn't matter if it is 1 month or 10 years.


Where's the inconsistency? The prognosis IS pretty damned good when you compare it to 15-20 years ago when people were told they'd better get their affairs in order because they'd be dead within 6-18 months. Just because the prognosis is MUCH better doesn't mean it's perfect.

Here in the UK, treatment is only offered when your numbers indicate a need. At least at my clinic, under my doctor.

And ignorance still isn't bliss. We need to get more people to test more often. It's the only way to slow this juggernaught down.

Ann
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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline mecch

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Re: Early Aging -- New York magazine article
« Reply #26 on: November 03, 2009, 09:18:41 am »
Where's the inconsistency?

Because many people in this forum know the different prognosis and different experiences. And yet when a person who is not a LTS comments on anything that touches LTS issues and experience, she/he is dumped on for painting too rosey a picture.

It works both ways.  You don't want our two cents, post it in LTS and not here.

Since its all conjecture, entertain in your mind overall good as well as negative outcomes of long-term infection, just as the doctors and researchers are doing now.

Maybe its a relatively rosey picture for some, and not for others.  Many factors involved.

You want this:  "We need to get more people to test more often."

Tell them what my doc says - normal life. Inconvenient and expensive, life-time medical surveillance and treatment.  
Or tell them what this article says:  Come get tested. If you are positive, we will give you drugs that will keep you alive but you'll degenerate long before your "normal" time into an old, incapable, handicapped person. Best we can offer.

Or maybe tell them the truth, which could be either experience. Correct???
« Last Edit: November 03, 2009, 09:25:25 am by mecch »
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline Miss Philicia

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Re: Early Aging -- New York magazine article
« Reply #27 on: November 03, 2009, 09:24:38 am »
sigh
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Offline Inchlingblue

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Re: Early Aging -- New York magazine article
« Reply #28 on: November 03, 2009, 10:25:27 am »

I don't know how many of you know of, or know, the indefatigable Jules Levin, but the take-away quote from the article for me is his:  

"Aging is the No. 1 problem in HIV today."

I appreciate an intelligent account about HIV and aging but I find this article to be alarmist and it contains inaccuracies. This is to be expected from any article about a serious subject covered by a mainstream popular magazine (as opposed to, say, a scientific journal).

If anyone wants a clearer picture of the latest knowledge about HIV and aging, I recommend digging deeper than an article in New York magazine. Not everyone has the inclination to slog through a scientific journal but there are excellent sources online that present the latest research intelligently and cogently. One good place to start would be the website that Jules Levin regularly writes for, the National AIDS Treatment Advocacy Project (www.natap.org).

 I've been poz for twleve and a half years, no meds, and the longer I'm poz, the more I see changes that can't all be down to the natural ageing process. In fact, I'm going to be talking to my doc about this very thing tomorrow.
 

Ann, having been able to thrive as long as you have without meds, I think your experience is so valuable.

One of the biggest challenges in understanding the effects of HIV on our bodies is the lack of information that would help tease out what is attributable to HIV and what is attributable to the meds.

Having said that, I was hoping you could share with the forum what specifically are the changes you're noticing that you can't attribute to natural aging? Inquiring minds want to know! :)

« Last Edit: November 03, 2009, 11:18:27 am by Inchlingblue »

Offline elf

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Re: Early Aging -- New York magazine article
« Reply #29 on: November 03, 2009, 11:10:39 am »
Some recent findings:


HIV and antiretroviral therapy: Impact on the central nervous system.
http://www.ncbi.nlm.nih.gov/pubmed/19857545?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=1

CNS Inflammation and Macrophage/Microglial Biology Associated with HIV-1 Infection
http://www.ncbi.nlm.nih.gov/pubmed/19768553?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=5

Good Neurocognitive Performance Measured by the International HIV Dementia Scale in Early HIV-1 Infection.
http://www.ncbi.nlm.nih.gov/pubmed/19641870?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=19

Resting cerebral blood flow: a potential biomarker of the effects of HIV in the brain.
http://www.ncbi.nlm.nih.gov/pubmed/19720977?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=9

The role of alcohol on platelets, thymus and cognitive performance among HIV-infected subjects: are they related?
http://www.ncbi.nlm.nih.gov/pubmed/19459132?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=48



4-Aminopyridine improves spatial memory in a murine model of HIV-1 encephalitis.
http://www.ncbi.nlm.nih.gov/pubmed/19462247?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=46


Offline Assurbanipal

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Re: Early Aging -- New York magazine article
« Reply #30 on: November 03, 2009, 11:33:59 am »
...to be honest that article terrified me for a very specific reason: the two examples it gave of people who succumbed to severe dementia were mentally active up to the moment of sudden collapse.  James L. had gotten a master's degree some time after 2001 and then a presumably demanding job; Donald was in law school and three weeks away from his degree.  Surely they were "constantly learning"?  And they don't appear to have been abusing drugs, or massively depressed, which are the things to which Dr. Margello attributed a lot of the dementia. 

Me too.  This not being a great time to go back into the job market, I've been thinking about returning to grad school and finishing up.  It would be a little awkward being a student again, espeically since the people I would want to work with are colleagues and we have published and even been on various scholarly panels together.  Still I'd been moving that direction, even invested in one of those GRE prep books, since my prior GRE's are almost 30 years ago (aging is good, I guess, but it sure goes fast  ;) )  And after the elections, I figured I would call and set up appointments and do up the app.  But this is pretty scary, both these guys sounded in some ways very similar, but perhaps infected another 5 or 10 years. 

Still, as Ann has pointed out, all we have is now. 





(

The test of a first-rate intelligence is the ability to hold two opposed ideas in mind at the same time and still retain the ability to function. --F. Scott Fitzgerald



Off topic, but every time I see this quote I wonder why on earth anyone would choose to quote F. Scott Fitzgerald on "the ability to function".  Have they never read his bio?  or Tender is the Night ?  No personal attack intended here Mecch, it's just that some authors as authorities on some topics . . . ??? 

(No doubt the inability to stay on topic reveals something dreadful about my current mental function  ::)






  )

5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%
2014 VL UD - 48
2015 VL 130 Moved to Triumeq

Offline Joe K

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Re: Early Aging -- New York magazine article
« Reply #31 on: November 03, 2009, 11:35:09 am »
Interesting article, but it does not mention the fact, that people who tested decades ago, did not have drugs that were reliable for reversing bad numbers.  For most of us, we tried all sorts of drugs to control our infection and it could be years before you saw any real improvement.  Granted, you were still alive, so that was good, however, exactly how much damage was done to our immune systems, while those drugs tried to gain the upper hand, will never be known.

I believe the main issues in regards to aging with HIV are, the effects of the virus itself, effects of medications and the timing of beginning treatment.  Yes natural aging is in there, but I find it hard to differentiate between aging and the virus, when I am falling apart at an accelerating rate.  It seems to me that we need to study the effects of these issues, but for different subsets of the HIV community.  For someone who is 25 years poz, those issues are vastly different from someone who has been poz for 5 or ten years.

I believe that the more accurate we can be, in describing issues that affect us, while keeping them in perspective and recognizing that there will never be "cookie cutter" guides to HIV infection.

One last point.  I know that some of you, think us dinosaurs are too quick to point out that living with HIV can be a real challenge.  Or that we tend to be very skeptical about claims that living with HIV, is now just a chronic illness and you can medicate your way to a bright future.  It is not that we do not share those hopes and dreams, it is because we have lived a very different reality.

I have been HIV poz for 25 years now and I still lose at least one person, each year, to HIV.  At the AMG memorial service I commented that I had lost so many people, that it equated to my losing someone, each and every month, for the past 25 years.  Over 300 people for me and I can assure you the numbers are in the hundreds, for all the other LTSers here.  It is not that we cannot embrace a new future of HIV treatment, it is that we come from a very different time and the only thing that we all share as a constant in our life, is the fact that HIV can and does kill.

So if our responses, seem tempered at times, please remember that we have seen people, who did everything right and yet, they died.  We have watched those who do nothing positive for themselves and yet, they live.  We have stood by those, who chose to forgo treatment and helped to usher them to their final resting.  We have witnessed so much, in regards to the reality of HIV, that, at least for me, I feel I have somewhat a duty to remind folks that HIV is a deadly disease, that if left untreated, will surely kill you.  While I try not to preach, I know the reality of living with HIV for me and if I share that history and it makes a few people uneasy, they need to try and see it, from my perspective.

Just as many of your experiences, will be very different in another 20 years, that is where us LTSers find ourselves today.  Fortunately, most of you will never experience what we did, the carnage and feelings of utter hopelessness.  However, please remember that we did experience what we did and that fact alone is what colors so much, of how we see HIV in context.  We don't begrudge this new era in treating HIV and hopefully it will become a chronic illness some day.  Until then, it is wise to remember that the only real constant with HIV, is the fact that it kills.  All the other stuff, is unique for each of us, however, sometimes you need a cold slap in the face, just to keep you on your toes.

Offline Ann

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Re: Early Aging -- New York magazine article
« Reply #32 on: November 03, 2009, 12:11:02 pm »

Ann, having been able to thrive as long as you have without meds, I think your experience is so valuable.

One of the biggest challenges in understanding the effects of HIV on our bodies is the lack of information that would help tease out what is attributable to HIV and what is attributable to the meds.

Having said that, I was hoping you could share with the forum what specifically are the changes you're noticing that you can't attribute to natural aging? Inquiring minds want to know! :)


I actually planned on doing exactly that, in a new thread. I'm writing this post from Liverpool where earlier today I had a very interesting discussion with The Wizard of Poz. Right now I'm in a cafe waiting for the taxi to take me to the airport and I'm absolutely knackered, so I'll write tomorrow. (I've been up since 4am, it's just gone 5pm now, and I won't be home until nearly 9pm - if the plane lands on time at 8:30pm) ::) :o

Ann
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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline leatherman

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Re: Early Aging -- New York magazine article
« Reply #33 on: November 03, 2009, 12:34:03 pm »
dementia by constant learning
My  grandfather, and many others like him,  who lost their mental facilities to alzheimers would love to believe that; but it's just not true. Sure there are things like diet and mental exercises that can help (my 92 yr old grandmother does the crossword puzzles in the paper every morning under the idea that is why she hasn't developed alzheimers - when actually it's not contagious but genetic); but "learning" or mental exercising, just like physical exercising,  is no guarantee of keeping away all health problems.
Some recent findings:
those reports seem to recommend that HIV does cause negative cognitive effects, and a possible solution could be chemical medication rather that "constant learning".  ::)  ;D


Tell them what my doc says - normal life. Inconvenient and expensive, life-time medical surveillance and treatment.
Without a crystal ball however, the doctor that tells you that quite frankly is lying. There is NO data to tell what the long-term consequences of taking these meds are, because no one has been on the meds long enough to give that data. Doctors are not gods nor do they have the power of foresight. They can only give educated guesses on your possible future. (Thankfully the three doctors that have predicted my death weren't very clairvoyant) However, this article and others are bringing to light the data doctors are still learning, and that seems to be that the consequences aren't always that "normal life" after all.


We don't begrudge this new era in treating HIV and hopefully it will become a chronic illness some day.  Until then, it is wise to remember that the only real constant with HIV, is the fact that it kills.
Goodness, it's either great minds thinking alike or hiv-deranged minds thinking alike. ;D I had written up a similar post in content (and in length ::)); but just hadn't gotten around to posting it as the responses have poured into the recent threads about this topic. However, I'll pull out these couple of paragraphs to add to your response.

All the treatments for this virus are still "new". There are no long term studies of either AZT, Atripla, Norvir or anything, because we are all still the guinea pigs producing the data. (LTSs have just been guinea pigs with a wider variety of meds and for much longer LOL) No doctor ever told me how any of these meds might destroy my life in 10, 15, or 20 yrs, because there was no information on that. They only told me that the meds had been shown to keep me alive "maybe" 5-20 yrs longer. After all the scientific articles I've read about HIV/AIDS and the meds over all these years, I'd be a little distrustful of a doctor that guaranteed me a "normal" life or lifespan. (Cause if they knew those sorts of answers from their crystal ball, they sure could have warned me about what was happening to Jim. I would have never let him stay to go through that hell in the hospital for 60 days before dying anyway - which sure was proof that untreated HIV/AIDS is still a terminal disease :'( ). However, I've often wondered just what shape I'll be in by the time a cure does come. I sure hope it comes before I lose my cognitive skills, my ability to walk, my eyesight, etc. But no doctor has ever guaranteed that either. All my doctors have offered is the hope that these meds will keep me alive long enough, and hopefully well enough, as each day is a day closer to a cure.

(If you'll allow me to paraphrase one line ;) )
living with HIV is now just a chronic illness and you can medicate your way to a bright future.
If your doctor told you that you'll be having a perfect life in 20-30 years from going onto your meds, well, that's excellent and more power to you. ;) (No one has ever yet lived to be 80 on Atripla for 40 yrs so I don't know that I would believe a doctor that suggested that to me.) I've seen enough side effects and death over the years, from people all over the spectrum of being medicated and not medicated, that I chose not to bury my head in the sand. I sure don't hope to have any of the more horrible problems; but I've always expected that in the end something from this terminal disease or the medications will catch up to me someday. So I keep trying to stay well-read on these issues and keep a watchful eye out on myself just in case I see the early signs. Thankfully on my trip down this road, just a step behind those first affected, I haven't had as many of the problems as others have; but I don't ever poo-poo them for their "negatively". For all I know lipo and the cognitive problems are just around the corner for me too. ::)

So far, there's no cure; but there are still side effects from the meds, and side effects that no one even knows about yet. If you don't want to know about what might be ahead on the road for you with HIV, I suggest to not look at the data, not listen to the personal stories, and hope for the best. But I'm still waiting for a cure - and still taking my meds until then. I'll tell you though that "waiting", even with all these problems and potential problems, is much better than the alternative of being dead. I sure wish Jim or Randy was still here waiting with me too. Instead they're dead and I'm enjoying life as best I can - even when it entails barfing, aches, cognitive issues, depression, osteroporsis, etc. and whatever other damage HIV and Reyataz, Norvir, Videc EC, and Viread is doing to me today.

ok, now everybody go take your meds, have happy thoughts, and enjoy the life you have today!  :-* ;D
leatherman (aka Michael)

We were standing all alone
You were leaning in to speak to me
Acting like a mover shaker
Dancing to Madonna then you kissed me
And I think about it all the time
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Offline skeebo1969

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Re: Early Aging -- New York magazine article
« Reply #34 on: November 03, 2009, 02:59:47 pm »



  I can't believe people are doubting the validity of what the article states.   It's almost like saying, hey seatbelts don't save lives because I've never been in an accident and had one save mine.  I can see applying scenarios to one's personal experiences and saying hey that does not apply to me, but on the other hand I think it's a bit ignorant to dismiss it in it's entirety as not being true or sensationalized even.

  Personal side note:  Damn is it hard to type responses while your computer is being attacked by a virus. These damn security alert windows are driving me crazy!
I despise the song Love is in the Air, you should too.

Offline GNYC09

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Re: Early Aging -- New York magazine article
« Reply #35 on: November 03, 2009, 07:20:03 pm »
I'm sharing an article I just read, which sadly supports the NY Mag article...

Neurocognitive Issues Plague HIV-Infected Patients Taking Antiretroviral Therapy: Presented at IDSA
By Ed Susman

PHILADELPHIA -- November 1, 2009 -- Neurocognitive impairment -- frequently seen among untreated subjects with HIV -- appears to persist among a substantial minority of patients treated with highly active antiretroviral therapy (HAART), according to researchers presenting here at the 47th Annual Meeting of the Infectious Diseases Society of America (IDSA).

"The introduction of HAART reduced the incidence of HIV-associated dementia by about 50%," said Abayomi Agbebi, MD, Washington University School of Medicine, St. Louis, Missouri. "Paradoxically, HAART does not reverse cognitive impairment in all patients."

Dr. Agbebi and colleagues found that 23% of HIV-infected subjects -- 182 of 793 patients -- attending the Washington University HIV clinic in 2008 in this prospective cross-sectional study had neurocognitive impairment, despite being on outpatient treatment with antiretroviral therapy.

"In the era of HAART, the prevalence of HIV-associated neurocognitive impairment remains high," Dr. Agbebi reported in a poster presentation here on October 30.

The research team conducted a multivariate analysis of factors that were associated with persistent neurocognitive impairment and found that older age (40+ years) and lower education (defined as people without a college-level degree) were significantly associated with cognitive impairment (P < .05).

"Persons with a college degree had a lower prevalence of cognitive impairment," Dr. Agbebi said. "Aging is a significant risk factor for cognitive impairment. As the HIV cohort ages, further investigation is needed into the effects of aging on HIV cognitive impairment."

The researchers found no association between neurocognitive impairment and gender, ethnicity, coinfection with hepatitis C, excess alcoholic intake, CD4-positive cell count, type of antiretroviral regimen, or whether a patient was taking an antiretroviral therapy that had central nervous system-penetrating agents.

"Multiple studies have shown certain antiretrovirals achieve a higher concentration in the cerebrospinal fluid," Dr. Agbebi noted. "Based on current evidence, antiretroviral cerebrospinal fluid levels cannot be used to choose a regimen."

The researchers added that the effect of high levels of antiretrovirals in cerebrospinal fluid remains controversial.

Funding for this study was provided by a grant from Bristol-Myers Squibb.

[Presentation title: HIV-Associated Neurocognitive Impairment Remains Prevalent in the Era of HAART. Abstract 351]

Offline Miss Philicia

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Re: Early Aging -- New York magazine article
« Reply #36 on: November 03, 2009, 07:43:51 pm »
Not sure why everyone is surprised by that considering all the constant whining about "brain fog".  I never get brain fog myself, because I use poppers.
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Offline edfu

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Re: Early Aging -- New York magazine article
« Reply #37 on: November 04, 2009, 02:21:26 am »
No wonder.... ;D
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Offline elf

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Re: Early Aging -- New York magazine article
« Reply #38 on: November 04, 2009, 03:39:57 am »
http://www.ncbi.nlm.nih.gov/pubmed/19685437?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=2
Neuronal protection by bioactive nutrients.




http://www.ncbi.nlm.nih.gov/pubmed/19523795?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=7
Omega-3 fatty acids and dementia.

Results to-date suggest that DHA may be more effective if it is begun early or used in conjunction with antioxidants.

Offline carousel

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Re: Early Aging -- New York magazine article
« Reply #39 on: November 04, 2009, 04:34:59 am »
The article raises serious issues and I think it is fair of people to tease out of it what is relevant and true for them and what is unsupported statements.  I think that is different from saying that it is a load of rubbish.

I'm afraid that I am one of those who chooses to put my head in sand when it comes to most of the medical information regarding HIV.  I am not on treatment after being diagnosed 5 years ago.  It is only a matter of time before I will have to face it, but I don't see why I should worry about the what ifs now.

In the same way that I didn't worry about dementia, Alzheimer's or any other degenerative disorder when I was well, I'm not going to worry my pretty little head on it now, I think.

Offline BT65

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Re: Early Aging -- New York magazine article
« Reply #40 on: November 04, 2009, 05:47:14 am »
http://www.ncbi.nlm.nih.gov/pubmed/19685437?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=2
Neuronal protection by bioactive nutrients.
http://www.ncbi.nlm.nih.gov/pubmed/19523795?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=7
Omega-3 fatty acids and dementia.

Results to-date suggest that DHA may be more effective if it is begun early or used in conjunction with antioxidants.

These things don't cure dementia/Alzheimer's however, dear, and it's really not 100% proven that it will stop these or their progression either.  Not saying don't help yourself, just saying.......

A lot of posts in this thread is why, with issues like this, I stick to the LTS'ers forum. 
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Offline carousel

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Re: Early Aging -- New York magazine article
« Reply #41 on: November 04, 2009, 06:04:11 am »

A lot of posts in this thread is why, with issues like this, I stick to the LTS'ers forum. 

But, thanks for popping by.

Offline minismom

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Re: Early Aging -- New York magazine article
« Reply #42 on: November 04, 2009, 07:15:35 am »
Long-term / short-term memory issues, DEXA scans, heart and liver issues, bowel and bladder issues, vision problems, tracking problems, dizziness, ringing of the ears, stiff joints, sore / weak muscles, avascular necrosis, lypoatrophy, lypodystrophy, wasting, diabetes, cerebral palsy, high cholesterol, high triglycerides - all wrapped up in body of a 9yr old.  I'd say early aging is definately associated with HIV/AIDS.  Is it the virus?  Is it the meds?  Does it really matter?

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« Last Edit: November 04, 2009, 07:24:23 am by minismom »
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Offline Nestor

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Re: Early Aging -- New York magazine article
« Reply #43 on: November 04, 2009, 10:27:09 am »
Elf,  thank you so much for these links, and the ones you posted earlier.  This is precisely the sort of thing we should be doing right now.  It's called lighting a candle rather than cursing the darkness.  They give real reason for hope.  And looking into anti-oxidants, omega-3s, turmeric, etc is precisely the kind of thing that would be wise right now, with the warning given in that article.  That, and looking into ways to fight or prevent bone loss, perhaps.

"These things don't cure dementia/Alzheimer's however, dear, and it's really not 100% proven that it will stop these or their progression either.  Not saying don't help yourself, just saying......."

Just saying what?  A lot of things haven't been 100% proven.  In fact very, very few things have.  What is the point?  I would agree with you if your "just saying" that we shouldn't become fanatically attached to things that may not be true, but you run the risk of sounding as if you were "just saying" that nothing works, nothing is proven, therefore we should all just give up hope and stop trying our foolish little attempts to improve our health any natural and sensible way we can.  I'm sure that that isn't what you meant, but in case someone interpreted it that way, I thought I'd ask.  For example, you go on to say:

"A lot of posts in this thread is why, with issues like this, I stick to the LTS'ers forum."  Again, I'm sure you are not referring to Elf's helpful post, but it might sound that way.  

  Minismom asks: "Is it the virus?  Is it the meds?  Does it really matter?"  With all due respect, I would submit that it matters very, very much.  How are we going to devise a strategy for dealing with something if we don't even know the cause?  Plus remember people like me who are dealing with the "when to start meds" question.  If it is the meds causing the dementia, bone loss etc., that means "put off the meds as long as possible."  If it is the HIV itself, then that would mean "start meds as soon as possible to restrict the virus right away.  I would think it matters very, very much.  

Thank you for listening.  

And by the way, I asked some posts back whether the proposal for testing and treating "every single adult in the Bronx and DC" meant forcing people to be tested and treated whether they wanted it or not, or simply making testing and treatment available should they wish it.  The quote in the article suggested the former.  
« Last Edit: November 04, 2009, 11:54:31 am by Nestor »
Summer 2004--became HIV+
Dec. 2005--found out

Date          CD4    %       VL
Jan. '06    725    25      9,097
Nov. '06    671    34     52,202
Apr. '07    553    30      24,270
Sept. '07  685    27       4,849
Jan. '08    825    29       4,749
Mar. '08    751    30     16,026
Aug. '08    653    30       3,108
Oct. '08     819    28     10,046
Jan '09      547    31     13,000
May '09     645   25        6,478
Aug. '09    688   30      19,571
Nov. '09     641    27       9,598
Feb. '10     638    27       4,480
May '10      687      9    799,000 (CMV)
July '10      600     21      31,000
Nov '10      682     24     15,000
June '11     563    23     210,000 (blasto)
July  '11      530    22      39,000
Aug '11      677     22      21,000
Sept. '12    747     15      14,000

Offline Ann

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Re: Early Aging -- New York magazine article
« Reply #44 on: November 04, 2009, 11:51:47 am »

And by the way, I asked some posts back whether the proposal for testing and treating "every single adult in the Bronx and DC" meant forcing people to be tested and treated whether they wanted it or not, or simply making testing and treatment available should they wish it.  The quote in the article suggested the former. 


It's not about FORCING people to test and go on treatment, it's about making testing much more available and easily accessed. It's about people being routinely offered testing when they see a doctor for whatever they're seeing the doctor for. It's about no longer keeping hiv in the dark. It's about increasing testing so we no longer have such high numbers of people running around (potentially spreading their virus) with no idea they're positive until they end up in hospital with PCP or worse.

We see it here all the time... "I tested positive when I was deathly ill in hospital with PCP". Or "I decided to have an hiv test and discovered my numbers are 153, 12%, 95,000!" If people are tested regularly as a matter of routine, they can discover they're hiv positive before they've progressed to an aids diagnosis and before they're on a ventilator because their lungs can't cope due to PCP. One of the leading causes in developed countries of aids-related deaths is LATE DIAGNOSIS.

~sigh~

Ann
« Last Edit: November 04, 2009, 11:53:30 am by Ann »
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Offline Miss Philicia

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Re: Early Aging -- New York magazine article
« Reply #45 on: November 04, 2009, 12:13:50 pm »
Nestor, while I can see how the language was a bit casual as regards the DC/Bronx issue in the article there's simply no legal way that they could do what you are imagining.  Let's be realistic about that.
"I’ve slept with enough men to know that I’m not gay"

Offline Nestor

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Re: Early Aging -- New York magazine article
« Reply #46 on: November 04, 2009, 12:36:47 pm »
Ann, thank you for that clarification.  I'm all for testing and treatment being available.  But the language of the article:

"In a dramatic move last week, the National Institute of Allergy and Infectious Diseases upped the ante even further by announcing a massive new plan to test virtually every single adult in the Bronx and the District of Columbia—homes to some of the highest rates of infection in the country—and put everybody who tests positive on anti-HIV drugs, whether they have depleted T-cell counts or not."

worried me because it didn't contain any reference to the freedom of the individuals involved to choose whether to get tested or not.  "put everybody who tests positive on anti-HIV drugs, whether or not..." sounds as if they don't have a choice in the matter.  That worried me.  It didn't say "give everybody...the option to take the drugs" or even "urge everybody...to take the drugs."  Just "put everybody on the drugs."  Probably it's that word "put" that bothered me most; when you say you're going to put a patient on a drug, it suggests that the patient has no agency in the matter.  Anyway, perhaps it's just me being hypersensitive.  

Summer 2004--became HIV+
Dec. 2005--found out

Date          CD4    %       VL
Jan. '06    725    25      9,097
Nov. '06    671    34     52,202
Apr. '07    553    30      24,270
Sept. '07  685    27       4,849
Jan. '08    825    29       4,749
Mar. '08    751    30     16,026
Aug. '08    653    30       3,108
Oct. '08     819    28     10,046
Jan '09      547    31     13,000
May '09     645   25        6,478
Aug. '09    688   30      19,571
Nov. '09     641    27       9,598
Feb. '10     638    27       4,480
May '10      687      9    799,000 (CMV)
July '10      600     21      31,000
Nov '10      682     24     15,000
June '11     563    23     210,000 (blasto)
July  '11      530    22      39,000
Aug '11      677     22      21,000
Sept. '12    747     15      14,000

Offline Nestor

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Re: Early Aging -- New York magazine article
« Reply #47 on: November 04, 2009, 12:44:31 pm »
Philicia, thank you too for that.  There's a sort of disease of "fearing that totalitarianism is always around the corner" and I wouldn't want to succumb to it! 

On another matter, I've been thinking a lot about the gulf between people who are criticising this article as "alarmist"and those who are offended by that position.  In a way I have a foot in both camps. Let me explain what I mean by that. 

One of the first comments I read in the comment box in the original New York Magazine site was from someone called Mikey who says:

"I'm 22 and HIV positive for 4 years. I think it's a bit absurd though that every time there is an article in regards to HIV/AIDS, authors and writers always have to put the negative aspects of it and the most advanced and horrible cases of the disease and just scare everybody....I face a lot of rejection in the dating world because of articles like this. People thinking that I take 80 pills a day, that I'm sick, I'm this, I'm that. You should perhaps do an article about people having healthy successful lives as well."

So of course, my first thought was "how selfish and narrow-minded; here are all these people suffering and he's thinking about his dating options."  And it didn't help that he went on to say "I've been in 3 relationships with negative men for long periods of time. They're all still negative and fine." Except that when you're 36, as I am, it sounds a little comical for a twenty-two-year-old to say that he's been in three relationships that each lasted "long periods of time", but then again the very young have a different relationship with time. 

 It may be that for someone like Mikey there are profound reasons why it is a good idea to think this way.  Might it not be that, if he gave serious thought to the implications of living with HIV for twenty years or more, he might go crazy from worry?  I do not have that luxury.  More than my own HIV diagnosis, it was the fact of losing someone very, very, close to me, to cancer, which has forced me to take a long-term view of health.  (As an aside, that person found out she had cancer and died less than two years later.  I got HIV and five and a half years later haven't even had a sniffle.  Which I remind myself of every time I'm tempted to feel sorry for myself or carry on as if having HIV were in itself a big deal.)  But my point is, I've spent a lot of time wondering whether doing this differently or that differently--in terms of everything from nutrition to spiritual development--might not have made things different for that person, and whether anything I can do now can make a difference in terms of my own long-term prospects of living with HIV.  So this article struck me as useful and a good thing to read on many levels.  For one thing, we should not be islands obsessed with our own personal situation; we need to know what our fellow human beings are going through.  For another, again, we need to know what issues we ourselves might face so we can think about dealing with and, one dares to hope, ameliorating them. 

At the same time, being 36 and healthier than most of my HIV-negative friends and having the same energy and desires I had before I tested positive, I want to scream sometimes at the way in which I am sometimes treated as a pariah because of my "condition".  One example: I was at a club about two years ago and I met a man whom I found very attractive and who seemed to like me as well.  After some conversation he invited me to his home--and, he said, not necessarily for sex, just for "conversation and warmth and cuddling" (his words).  That was fine, although to be honest sex was in the air.  At any rate, for some reason, I told him then that I was HIV positive.  Why, I have no idea, but I thought that if I did get to his home, and things got passionate, I would not have the strength to tell him at that point, and I had listened to the rhetoric about the necessity to disclose.  Well, he immediately pulled back and became somewhat frigid and said that in that case it wouldn't be a good idea.  He explained that he was a doctor and "it's just that I'm surrounded by it at work."  It?  Am I an "it" now?  And this is a medical professional, and basically even "conversation and warmth etc. etc." are out of bounds now that I have "it"?  I'm sure many of us have been in this sort of situation and we all know what it does to our minds.  And then there's the sheer hysteria which surrounds so many negative people's fears of getting HIV; and then there were conversations online where HIV- gay men said things so hurtful that I wouldn't dare repeat them here.  (okay, just one example: on gay.com, there's one man who, every single time HIV is the topic of a thread, is sure to pop up and say "Responsible people don't get HIV.")  This is what is meant by "stigma".

So this is why I understand Mikey despite the degree of insensitivity apparent in his reply.  He's twenty-two and he wants to go out and have fun and instead he's got the albatross of this virus around his neck.  And by the way it fills me sadness to hear a 22-year-old blithely telling us that he's had HIV for four years---since he was eighteen?  So, rightly or wrongly, he identifies stigma with this fear of illness, and thinks that if it weren't for articles of this sort in New York magazine, he could succeed in telling the guys he meets on the dance floor that having HIV is no big deal, and that they might believe him, and that then stigma might go away.  Obviously I don't think that the correct way of fighting against stigma is to hide the truth about the current medical situation (magna est veritas et praevalebit) but I can understand the temptation to do so. 
Summer 2004--became HIV+
Dec. 2005--found out

Date          CD4    %       VL
Jan. '06    725    25      9,097
Nov. '06    671    34     52,202
Apr. '07    553    30      24,270
Sept. '07  685    27       4,849
Jan. '08    825    29       4,749
Mar. '08    751    30     16,026
Aug. '08    653    30       3,108
Oct. '08     819    28     10,046
Jan '09      547    31     13,000
May '09     645   25        6,478
Aug. '09    688   30      19,571
Nov. '09     641    27       9,598
Feb. '10     638    27       4,480
May '10      687      9    799,000 (CMV)
July '10      600     21      31,000
Nov '10      682     24     15,000
June '11     563    23     210,000 (blasto)
July  '11      530    22      39,000
Aug '11      677     22      21,000
Sept. '12    747     15      14,000

Offline BT65

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Re: Early Aging -- New York magazine article
« Reply #48 on: November 04, 2009, 02:06:53 pm »
Nestor, I'm at work, and for some reason, the quote function won't work right, but I wanted to let you know something.

We, at least a lot of us, back in the stone age, would hold out that "natural" things would "cure" Aids.  It never happened.  And a lot of us spent a lot of money on these things.  Money that we could have better used for whatever, hell, things that really brought us enjoyment.  Like I said, I didn't say don't help yourself.  But, depending on these things, do not wipe out events that will happen due to ongoing HIV. 

I've been positive for 20 fucking years, and used to have a whole shoe box full of supplements, and vitamins.  And it did nothing for my health.  Well, except maybe tax my liver more.  And yes, I do take a multi vitamin, calcium w/ D and occasionally a "C."  I don't overload myself on these things anymore.  You do what you want.
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Offline skeebo1969

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Re: Early Aging -- New York magazine article
« Reply #49 on: November 04, 2009, 03:44:58 pm »


  Which thread is this?  Is this the one on early aging or the progam being offered in DC?

 
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