Thursday, 30 May 2013

THE ELUSIVE 500!

Stats update, i'm back at 498 from a low of 382 two months ago. so am back to "not wanting to get meds" ulit.

it was actually a steady improvement for 1 1/2 years until i got some bacterial infection last february that led to some neuropathic problems (unrelated to my serostatus). i was under medications which is expected to bring my immune system down. fortunately i recovered fast in just a matter of 3 weeks and my doctor said that it's a sign that despite my HIV status my immune system seems strong.

true enough my cd4 went down 382 last february and the doctor recommended that i start ARVs na. i hesitated and decided to wait another 3 months and see if my cd4 count would improve. nevertheless they started me on 6mo of daily doze isoniazid which is a phropylactic medications for TB.

and now the great news --- as of May my cd4 is up at 498 and i should say back on track.

improving without ARV medications.

something that i am very thankful of.

hindi nagpapatalo ang immune system ko, palaban pa rin.

i dont know how long they can hold this fight and i sincerely hope that they would not need medicinal reinforcements soon.

but then again there are a lot of study pointing to early medications as very beneficial to PLHIVs and that it will promise better protection for my sexual partner (bf). kaya mahirap pa rin magdecide i am torn between keeping a status quo and try to live a healthy life free of medications. or starting a new life on medications which can potentially impact my lifestyle.

for now am choosing the easier route of the status quo. i think my immune system deserves a chance to prove itself and fight this virus without reinforcements.

the elusive 500 cd4 count, i hope in another 3 months time i get to that mark or higher. it will surely make my resolve stronger that despite my serostatus, my body is winning the battle, for now.

ito ang aking diary

ako si BONG

 

Wednesday, 15 May 2013

HIV MEDS ADHERENCE???

Exactly what level of adherence to HIV medications is required to maintain virological control?

Dear Dr. Young:

This is a question that has always intrigued me, ever since I started on an effective antiretroviral treatment combination in 1997. Back then we were warned that even missing a single dose of our medications could spell disaster i.e. HIV resistance and subsequent loss of virological control. So I mustered all the self-discipline I could and took my medications as "correctly" as humanly possible and attained virological control (viral load measurements below the limit of quantification using whatever technology at the time) that I have maintained. Recently I undertook a very rigorous audit of my adherence that disclosed that in fact I take about 99 per cent of my doses and completely miss about one per cent in a one-year timeframe. Despite this error and lack of perfection my viral load remains undectable. I was just curious because even with the utmost of care that I bring to the task I still fall short of one hundred per cent perfection. Thank you for any insight you can provide.

Please accept my best regards,

Wayne Toronto, Canada

______________________

Response from Dr. Young

Hi Wayne and thanks for posting from Canada.

Perfection might be a goal, but rarely achieved.

You're adherence is exemplary- 99% is excellent and not associated with any decline in viral suppression. I would not be concerned about a 1% missed dose at all.

While we continue to quote a 95% goal (from a ~1999 study), with current medications, it's quite likely that lower levels of adherence continue to provide very good viral suppression.

In my clinic of less-than-perfect patients, loss of viral control has been exceptionally rare, and often the result of complete discontinuation of medications, rather than the inadvertent missed dose. So, worry not.

Be well, BY


Source: http://www.thebody.com/Forums/AIDS/Meds/Q229268.html?ic=700101

 

Sunday, 5 May 2013

THE CURE! IS IT ALMOST HERE?

By Jake Wallis Simons (6:30PM BST 27 Apr 2013)

Source: http://www.telegraph.co.uk/health/healthnews/10022664/Scientists-hope-for-HIV-cure.html

Researchers are working on "novel strategies" to find a cure for HIV, with the first results expected “within months”.

Danish scientists are hoping for results that will show that “finding a mass-distributable and affordable cure to HIV is possible”.

They are conducting a clinical trial to test a “novel strategy” in which the HIV virus is "reactivated" from its hiding place within human DNA and potentially destroyed permanently by the immune system.

The move would represent a step forward in the attempt to find a cure for the virus, which causes Aids.

The scientists are currently conducting human trials on their treatment, in the hope of proving that it is effective. It has already been found to work in laboratory tests.

The technique involves unmasking the “reservoirs” formed by the HIV virus inside resting immune cells, bringing it to the surface of the cells. Once it comes to the surface, the body’s natural immune system may be able to kill the virus.

In vitro studies — those that use human cells in a laboratory — of the new technique proved so successful that in January, the Danish Research Council awarded the team 12 million Danish kroner (£1.5 million) to pursue their findings in clinical trials with human subjects.

These are now under way, and according to Dr Ole Søgaard, a senior researcher at the Aarhus University Hospital in Denmark and part of the research team, the early signs are “promising”.

“I am almost certain that we will be successful in activating HIV from the reservoirs," he said.

“The challenge will be getting the patients’ immune system to recognise the virus and destroy it. This depends on the strength and sensitivity of individual immune systems, as well as how large a proportion of the hidden HIV is unmasked.”

Fifteen patients are currently taking part in the trials, and ithe first results from the trial are expected to presented in the second half of 2013.

Dr Søgaard stressed that a cure is not the same as a preventative vaccine, and that raising awareness of unsafe behaviour, including unprotected sex and sharing needles, remains of paramount importance in combating HIV.

With modern HIV treatment, a patient can live an almost normal life, even into old age, with limited side effects.

However, if medication is stopped, HIV reservoirs become active and start to produce more of the virus, meaning that symptoms can reappear within two weeks.

Finding a cure would free a patient from the need to take continuous HIV medication, and save health services billions of pounds.

The technique is being researched in Britain, but studies have not yet moved on to the clinical trial stage. Five universities — Oxford, Cambridge, Imperial College, London, University College, London and King’s College, London — have jointly formed the Collaborative HIV Eradication of Reservoirs UK Biomedical Research Centre group (CHERUB), which is dedicated to finding an HIV cure.

They have applied to the Medical Research Council for funding to conduct clinical trials, which will seek to combine techniques to release the reservoirs of HIV with "immunotherapy", which gives patients a better chance of destroying the virus.

In addition, they are focusing on patients that have only recently been infected, as they believe this will improve chances of a cure. The group hopes to receive a funding decision in May.

“When the first patient is cured in this way it will be a spectacular moment,” says Dr John Frater, a clinical research fellow at the Nuffield School of Medicine, Oxford University, and a member of the CHERUB group.

“It will prove that we are heading in the right direction and demonstrate that a cure is possible. But I think it will be five years before we see a cure that can be offered on a large scale.”

The Danish team’s research is among the most advanced and fast moving in the world, as that they have streamlined the process of putting the latest basic science discoveries into clinical testing.

This means that researchers can progress more quickly to clinical trials, accelerating the process and reaching reliable results sooner than many others.

The technique uses drugs called HDAC Inhibitors, which are more commonly used in treating cancer, to drive out the HIV from a patient’s DNA and onto the surface of infected cells. The Danish researchers are using a particularly powerful type of HDAC inhibitor.

Five years ago, the general consensus was that HIV could not be cured. But then Timothy Ray Brown, an HIV sufferer — who has become known in the field as the Berlin Patient — developed leukaemia.

He had a bone marrow transplant from a donor with a rare genetic mutation that made his cells resistant to HIV. As a result, in 2007 Mr Brown became the first man to ever be fully cured of the disease.

Replicating this procedure on a mass scale is impossible. Nevertheless, the Brown case caused a sea change in research, with scientists focusing on finding a cure as well as suppressing the symptoms.

Two principal approaches are currently being pursued. The first, gene therapy, aims to make a patient’s immune system resistant to HIV. This is complex and expensive, and not easily transferrable to diverse gene pools around the world.

The second approach is the one being pursued by Dr Søgaard and his colleagues in Denmark, the CHERUB group in Britain, and by other laboratories in the United States and Europe.