Is there anything else that works?

[JamieD]

Is there anything else, other then HAART, that has been proven to reduce the viral load of HIV+ people? Even if it is only 1,000 copies, is there anything that has been PROVEN to actually lower the viral load at all other then the medications?

[milker]

There are interesting studies that are coming out about N-acetylglucosamine (a natural glycoproteine) and its effect on gp160 or gp120 (i don't remember which one), but I don't think there's been any full scale study done on humans yet. Alternative non-designer peptides are always interesting for us, but not really for big pharma.

To attack the viral load as opposed to attacking the virus when it's in the cell, you need to generate a specific protein breakdown, or protein shape change, so that the CD4 binding is impaired.

Milker.

[aztecan]

To answer your question, no, at this point in time there isn't anything aside from HAART that will effectively help reduce the viral load.

HAART these days is nothing like the old days and there are quite a few options out there.

HUGS,

Mark

[JPinLA]

Echoing both replies - while there have been suggested in vitro correlations of other factors that could prevent HIV from entering  cells nothing other than HAART has been proven clinically to reduce viral load - to my knowledge (which by my own admission is limited).

JP

[Carolann]

To echo Aztecan, no, no, no. HAART has been the only strategy that has drastically cut down the mortality rate of HIV infected people. Now, there are things that help you stay healthier, like protected sex, no drugs and alcohol, exercise, a healthy diet... Beware of snake oil salesmen as they abound and are ready to prey upon those early diagnosed and those in denial.

CA

[J220]

Indeed..right now, no. In the near future, as in after October, yes. The FDA should be approving at least one new med that works outside the resistance envelope, if all goes well. Things are definitely moving in the research front. Read the following:

http://forums.poz.com/index.php?topic=12874.0

Cheers, J.

[Cerrid]

Indeed..right now, no. In the near future, as in after October, yes.

The new meds are integrase inhibitors and CCR5 antagonists, two completely new drug classes to fight HIV. Still, they are and will be part of HAART. You'll still need drugs of the established 3 drug classes to combine them with.

[J220]

The new meds are integrase inhibitors and CCR5 antagonists, two completely new drug classes to fight HIV. Still, they are and will be part of HAART. You'll still need drugs of the established 3 drug classes to combine them with.

Good point. I hope, however, to see these drugs become a monotherapy regime as time goes by, and their efficacy as such is further established. Main reason I say this is the very low incidence of side effects, as well as their mechanism of action.
I wouldn't be surprised if the integrase inhibitors become the first-line, long-term therapy of choice. The CCR5 antagonist, on the other hand, I think would not make it that far, because if I understand this correctly, some hiv variants don't use the CCR5 receptors, but others. J.

[redhotmuslbear]

Good point. I hope, however, to see these drugs become a monotherapy regime as time goes by, and their efficacy as such is further established. Main reason I say this is the very low incidence of side effects, as well as their mechanism of action.

Very few side effects..... sounds like so many drugs in relatively short-term studies, then we find out how deforming they can be with long-term use.  What about costs, too?  Inusrance companies, ADAPs and other payors will be hesitant to fund a front-line therapy that is far more expensive than existing meds.

[aztecan]

Very few side effects..... sounds like so many drugs in relatively short-term studies, then we find out how deforming they can be with long-term use.  What about costs, too?  Insurance companies, ADAPs and other payors will be hesitant to fund a front-line therapy that is far more expensive than existing meds.

You make some excellent points. In 1996, Crixivan was a wonder drug, saving lives. It still does that, as does Zerit, etc., but we now know the other side of the coin: PN, lipo, etc.

Mind you, when weighed against death, the side effects are acceptable. But when you talk about long-term quality of life, there may be some caveats.

The point about cost is also relevant. Right now, my state will not pay for Fuzeon unless there is documented proof from the doctor showing it is necessary - which is why it is considered salvage therapy here. At $20,000 a year just by itself, it is cost prohibitive.

The Indian Health Service does not prescribe Atripla for the same reason - cost. IHS docs can prescribe Sustiva/Truvada, but not Atripla, unless the patient is paying for it out of his own pocket.

Atripla may be the drug du jour, but it isn't cheap. I have known several people here who have had to fight Medicaid, file appeals, etc., in order to get it. The reason? It costs about $16,800 a year.

So, while I hold out hope for advances, I also view them with a somewhat jaded eye because I know many, probably including myself, may not be able to access them because of cost.

HUGS,

Mark