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Biotech / Medical : Agouron Pharmaceuticals (AGPH) -- Ignore unavailable to you. Want to Upgrade?

To: billkirn who wrote (4414)	5/30/1998 7:27:00 PM
From: Peter Singleton	Read Replies (1) \| Respond to of 6136

Thought this was relevant to the issue of whether PI use would expand in the asymptomatic, diagnosed patient population. Here's a long, interesting article on rebuilding the immune system in HAART. nam.org.uk Lots of new research on the ability of HAART to reconstitute the immune system, even in cases where viral replication has not been completely suppressed. Much of this was presented in Chicago in February (and was noted by folks on this thread back then ...) Several key quotes: /* damage to the immune system in untreated HIV infection "When the CD4 count falls in someone with untreated HIV infection, both na‹ve and memory cells are being lost. The loss of na‹ve cells reduces the body's ability to respond to new antigens, while the loss of memory cells leaves 'gaps' in the immune system where it can no longer respond to antigens it has encountered in the past." /* Probably the only comment in the article that offered a counterpoint to the argument for early and aggressive anti-retroviral treatment "These studies are grounds for considerable optimism. They suggest that even people who start treatment relatively late may enjoy real and substantial improvements in their immune functions - questioning the need for 'hitting early' with anti-HIV drugs. Even if immune damage caused by HIV has left 'gaps' in their immune repertoire, there is now hope that these may eventually be 'plugged' by newly-formed na‹ve CD4 cells." /* Discussion about starting anti-retroviral treatment immediately, if HIV infection is detected in the primary infection stage (c. first 6 months). Optimistic mention of Dr. Bruce Walker's study of 11 patients so treated ... "Debate continues about the pros and cons of starting anti-HIV treatment during the first days and weeks after exposure to HIV (primary infection). Some researchers believe that very early treatment could be harmful. Pointing to the research summarised above, they argue that suppressing HIV during primary infection may result in less vigorous HIV-specific immune responses. Others agree that strong HIV-specific immune responses are important, but think that the latest research actually strengthens the case for treating primary infection. Dr Bruce Walker, an immunologist in Massachusetts, presented his theory about why the immune system usually fails to mount an effective response to HIV. His studies suggest that soon after infection, long-term non-progressors (HIV-infected people who maintain high CD4 counts and good health for many years without requiring anti-HIV treatments) develop high levels of CD8 cells that specifically target HIV. For the body to produce these cells, CD4 cells must first detect HIV and become activated. But activated CD4 cells are HIV's preferred target cells - so the virus infects and kills the very cells that could stimulate an effective immune response. Dr Walker argued that if newly infected people are treated with HAART regimens within six months of exposure to HIV, it may be possible to prevent activated CD4 cells from being infected and destroyed, allowing strong CD8 responses to develop. He reported eleven cases of people who started treatment during seroconversion and now have undetectable viral load and very strong immune responses against HIV, similar to those seen in long-term non-progressors."