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Author Topic: Treat all HIV infections, Global Panel Says  (Read 8337 times)

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Offline spacebarsux

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Re: Treat all HIV infections, Global Panel Says
« Reply #50 on: August 01, 2012, 05:26:49 AM »
Except, dear expert panel at the World AIDS Conference, there is no decent evidence to say, in terms of individual health outcomes, treatment at a CD4 count above 500 (or to be strict perhaps 350) reduces risk of death or illness more than fractionally. And there is still minimal long term evidence on side effects from current combination therapy.

From the perspective of an individual's health, this ^^, in my opinion, is the nub of the matter. Hence the importance START clinical trial results, which are still awaited.

From a public health standpoint, there are cogent reasons to commence therapy soon; however, concerns regarding the untested pozzie unwittingly perpetuating onward infections largely remains unaddressed, and would continue to be the main source of most infections. So I guess, you'd have views on both sides of the fence.
Infected-  2005 or early 2006; Diagnosed- Jan 28th, 2011; Feb '11- CD4 754 @34%, VL- 39K; July '11- CD4 907@26%,  VL-81K; Feb '12- CD4 713 @31%, VL- 41K, Nov '12- CD4- 827@31%

Offline friskyguy

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  • Posts: 109
Re: Treat all HIV infections, Global Panel Says
« Reply #51 on: August 01, 2012, 07:06:42 AM »
focusing on CD4 counts is truly only part of it.......mainly focusing on the CD4 counts as a trigger (and a looksee at your VL) to commence meds maybe not a smart move?.....

For instance....

What about the consequences of rampant viral replication of untreated HIV that lurks in our body tissues and in organs? What irreparable and long term damage may THAT be doing to some or all of us? .......inflammation anyone?

What about viral replication not only in CD4 cells....yes HIV infects other cells as well.......like in macrophages....but we are unlikely to test for that or see what is happening there.

Ive read where some patients, who are virally supressed and UD in their blood (due to meds),.....yet the virus is still active and replicating in the CNS.....dementia anyone?

I reckon with the mounting evidence building, 'the when to treat pendulum' will freeze where it is now and won't swing back......anyway as time goes on we will know for sure.....perhaps......anyway we all have the luxury of time....don't we!??

just saying

Sero converted Sept '10 / Confirmed + Dec '10
Jan '11, VL 9,500 / CD4 482 (32%)
Feb '11, VL 5,800 / CD4 680 (37%)
start Atripla
Mch '11, VL UD / CD4 700 (42%)
Jun  '11, VL UD / CD4 750 (43%)
swap to Kivexa and Efav. due to osteopenia diag. (DEXA) / kidney issues ( decline in eGFR to 77 )
start supplements - Vit D3 / Omega 3 / multivitamin / mini aspirin
Dec '11,  VL UD <20 /  CD4 670 (49%)  / CD4:CD8 = 1.4
all labs now within normal ranges
Mch '12,  VL UD / CD4 600 (51%)
Sep '12,  VL UD / CD4 810 (51%)
Mch '13   VL UD / CD4 965 (56%)
Sep '13   VL UD / CD4 (not taken)
Dec '13   VL UD / CD4 901 (35%) / CD4:CD8 = 1.1  /  eGFR > 100

Offline madbrain

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Re: Treat all HIV infections, Global Panel Says
« Reply #52 on: August 02, 2012, 04:01:19 AM »
Except, dear expert panel at the World AIDS Conference, there is no decent evidence to say, in terms of individual health outcomes, treatment at a CD4 count above 500 (or to be strict perhaps 350) reduces risk of death or illness more than fractionally. And there is still minimal long term evidence on side effects from current combination therapy.

Death and illnesses are not necessarily the only metrics to use. General well-being is probably too vague and not sufficiently objective to scientifically measure, but there is at least anecdotal evidence of some improvements for starting treatment even at those higher CD4 counts.

 


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