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August 29, 2006

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Pharma Bawd

Jeeze Gene,

Last thread I'm threatened with banishment for bringing up Hank's favorite study in a way he doesn't like, and in this one all I want to talk about is how Hank has misrepresented, ie. lied, about the findings of the Lancet study that is the subject of the post and everybody wants to talk about other topics. ????

The truth is I haven't even read your comments on PCP because I'm busy enough reading the Lance and about Low Dose Naltrexone at the moment.

Hank,

Don't you feel guilty now that Dean is ignorantly repeating your lie?

Michael

Pharma Bawd.

You wrote:

"But HAART can also effect HIV replication in the gut and prevent the long term depletion of CD4 cells in gut associated lymphoid tissues, which is by far the largest reservoir of CD4 cells in the body."

Unfortunately, dear believer in "I must have clinical trials", none of the trials of any of the HAART drugs have ever been tried against any control group of HIV positives who do not or will not take the drugs.

The HAART drugs have NEVER ever been tried against any control group of people not taking them, therefore all results from these studies are invalidated from the start.

The many Long Term Non-Progressors also teach us a very important lesson, besides avoid drug abuse and toxic meds. They teach us the following:

Simply giving one's own self permission to heal, in the form of expectations of health and well being, also works wonders for increasing the Tcells and Lowering the supposed virus!

We all know, and all the pharmaceutical and scientific and medical communities know, that the placebo effect has quite often showed us pill popping to be a wash. Why this is, you, me, and the rest of science is at a loss to understand.

Seems to be something to do with one having permission to be well and permission to recover from illness. Whether the permission to heal and be well comes from a doctor, a pill, or from ones own inner confidence and self, it is obviously a powerful effector of health.

Michael

The only thing to add to the above, is that patients, who are terrified by the diagnosis, or terrified by the proclamations and fears of their inept doctors are completely unable to give themselves permission to heal.

An incompetent doctor, is one who would do such an insensitive thing to begin with as to spread the doctors own fears and spread their own proclamations of impending illness, to the overly trusting patient.

Seems to me, the patients who are sceptics manage to heal on their own, while the terrified believers that HIV is gonna get them need outside intervention and permission to heal in the form of a pill or the re-assurance of a competent doctor.

noreen martin

Michael, you're getting into some heavy stuff but you're right. Those who find it necessary to take a pill probably will do better because they think that they will. The other side of the coin, people like myself, who do not have faith in long term use of HAART, will be better off without them. Although, it has been proven that stress does have an affect on CD4's, if one chooses to place significance in them, nevertheless, the very real, side affects of the anti-virals are not in one's head and will be reflected in one's health.

Pharma Bawd

Sorry Michael,

I’ve heard this one before:

“none of the trials of any of the HAART drugs have ever been tried against any control group of HIV positives who do not or will not take the drugs.”

Didn’t sound right to me, so I did some reading and came across this study:

“In a failure-rate model, increases in the intensity of antiretroviral therapy (classified as none, monotherapy, combination therapy without a protease inhibitor, and combination therapy with a protease inhibitor) were associated with stepwise reductions in morbidity and mortality. Combination antiretroviral therapy was associated with the most benefit; the inclusion of protease inhibitors in such regimens conferred additional benefit.”

That’s:
none (no anti-retrovirals) ie: the control group,
vs
monotherapy (like AZT alone),
vs.
combined anti-retrovirals,
vs
combined anti-retrovirals + Protease inhibitor ie: HAART

Morbidity and mortality decreased in a stepwise fashion going down the line.
http://content.nejm.org/cgi/content/abstract/338/13/853

So please, can we drop statements like this one:

“The HAART drugs have NEVER ever been tried against any control group of people not taking them, therefore all results from these studies are invalidated from the start.”

This was a large study of 1255 patients, AZT works better than nothing, and HAART works better than AZT.

Pharma Bawd

Michael,

The rest of your comment sounds like "faith based" medicine to me. Are you a Creationist?

Myself, I'll take science thanks.

lise

I’ve heard this one before:

“none of the trials of any of the "HAART drugs have ever been tried against any control group of HIV positives who do not or will not take the drugs.”

Didn’t sound right to me, so I did some reading and came across this study:. . ."

PB, the obviously very impressive research you've done, was that before or after you started pushing?

Pharma Bawd

Lise,

After.

Any thoughts on the data? (which was collected well before I became interested in the topic)

Sims

"The rest of your comment sounds like "faith based" medicine to me. Are you a Creationist?

Myself, I'll take science thanks."

Ha! You can take it and keep it!
Creationism is what Robert Gallo did in 1984, and his cronies have been doing ever since, pharma-brain.

noreen martin

Pharma Bawd, what do you think about LDN? Why don't we do a clinical trial and place LDN up against any HAART combination. I'm just one person, but there are others out there doing the same thing. Follow me, check out my progress. I am prejudging the results, but I believe that those on LDN will do better because their blood work will not be screwed up and their OI's will be practically nonexistant. Their CD4's may not be as high as the Aids doctors think that they shoud be, nevertheless, what is really important, some number or health?

George

How's this for a "stunning contradiction"?

There is a *very* long thread at NAR which has many interwoven comments concerning vertical vs horizontal modes of retroviral transmission. For the most part it is extremely confusing. However, near what is now the C-terminus, Michael (I believe the one we all know from Barnes-world) makes what I consider a brilliant, insurgent suggestion that puts a rocket-loaded AK47 in everyone's hands.

The suggestion is that anyone who receives a posititve antibody test should immediately (if not sooner) have their mother tested. For *some* the result will engender the child saying, between guffaws, "Gee mom, all these years and we never knew you had AIDS!"

I suggest another button Hank.

This one says:

"My Mom is POSITIVE, and So Am I.
HIV is NOT The Cause of AIDS"

Michael

Is anybody signed up with NEJM to take a look at PharmaBawd's study there.

http://content.nejm.org/cgi/content/abstract/338/13/853

It is highly suspect for a couple of reasons.

One: The study was begun in 1994 and went through 1997, when a lot of patients were still on, or just coming off of high dose AZT.
The prior use of high dose AZT would effect health for years to come.

TWO: I am wondering if the control group of patients who supposedly received "no treatment" were a true "treatment naive" group, meaning they never took AZT monotherapy, or, if they were former users of "High Dosage AZT" that were now off the AZT after it had assisted in further destroying their immune systems.

Three: How many in either group were still drug addicts that were also screwed up by highly destructive drugs such as crystal meth?

The study looks to me to have been performed for one reason: to push doctors to get people off the high dose AZT and to push them onto the new meds, and preferably as many meds as possible.

We all know the result of that, is that most patients after this point died of liver failure, and suffered extreme side effects of physical deterioration and disfigurement from drug induced lipodystrophy. We also know, and Lancet confirms no evidence of extended life while taking these newer cocktails and ARV drugs.

Gene Semon

Fair enough, Pharma Bawd, but first of all it's not about "lying" since the study you cite is NOT one of the "surrogate marker" studies that don't include contol groups, which is what Hank is talking about. If I can add anything to Michael's response it would be that perhaps the "lying" is being done by those who persuade gullible people that CD4 cell-decline can represent a collapse of "cell mediated immunity".

Now moving on to a REAL disease and the appropriate drug treatment, we have more on PCP:

"Pneumocystis carinii synthesizes a number of distinct 7 and 8 24-alkylsterols but not ergosterol (the target of several antimycotics), and the organism scavenges cholesterol from its mammalian host. Most fungal sterols have an alkyl group consisting of one carbon at C-24 of the side chain. In contrast, the sterols of P. carinii and many plants have either one or two carbons at that site (C28 and C29 sterols). The P. carinii sterols are excellent chemotherapeutic targets because mammals cannot synthesize 24-alkylsterols.

"NO CORRELATION between human immunodeficiency virus infection (HIV) and high levels of pneumocysterol was found." (EMPHASIS ADDED)

Zunika Amit and Edna S. Kaneshiro. Heterogeneity of Pneumocystis Sterol Profiles of Samples from Different Sites in the Same Pair of Lungs Suggests Coinfection by Distinct Organism Populations. Journal of Clinical Microbiology, March 2001, p. 1137-1139, Vol. 39, No. 3 http://jcm.asm.org/cgi/content/full/39/3/1137

Michael

Pharma Bawd,

As regards your study, claiming some recieved non-treatment as a third control group.

Non-treatment as a control group is not a placebo control group. As long as a placebo group was not included, the results of the study are extremely limited and quite invalidated.

Lise

PB, being quite serious here since I don't know you: you collecteed data like the above even before you became interested in the topic?? I think I need to know a little bit more about your professional or hobby background.

I have no thoughts on the numbers apart from what's already been said. But - don't want to sound superstitious here - but to stake your soul on an article that's co-authored by Loveless and Fuhrer. Doesn't that chill you a bit??

Pharma Bawd

Noreen,

I have no problem with it. But I’m not the one you need to convince to do a clinical trial. One of the criteria that it would be judged against HAART by will definitely be viral load. I know it isn’t going to be popular to point this out here, but viral load is a very good predictor of progression to AIDS and to death.
http://www.sciencemag.org/cgi/content/abstract/272/5265/1167

Pharma Bawd

Michael,

Check your email.

1. “The prior use of high dose AZT would effect health for years to come.” Many of the patients had prior use of some kind, however they could have ended up in any of the four treatment categories. The paper doesn’t break out prior treatments.

2. The patients are not treatment naive. “This report outlines the changes in death rates and the incidence of opportunistic infections in a large group of HIV-infected outpatients, many of whom had previously received extensive treatment.”

3. 14% of the patients were injecting drug users, this number was constant over the course of the study. Although IV drug users had a higher death rate than other risk groups they experienced a similar decrease in mortality to the other risk groups. There’s no information on other “recreational” drugs.

What we haven’t gone into in this thread, because Hank never responded to my questions, is that this:

“We also know, and Lancet confirms no evidence of extended life while taking these newer cocktails and ARV drugs.”

Is a completely false statement. If you’d like to discuss what the Lancet paper actually shows I’d be happy to send it to you. I’ve already linked to data that show the effectiveness of HAART in reducing mortality above. See Figure 1:
http://momentofscience.blogspot.com/2006/08/figures.html

Pharma Bawd

Michael,

“Non-treatment as a control group is not a placebo control group.”

Fair enough, they’re not the same, but they are pretty close. It’s a study not a double-blind placebo controlled clinical trial, in that context they’re roughly equivalent. However, I did link to a double-blind placebo controlled trial of AZT vs placebo above:
http://momentofscience.blogspot.com/2006/08/figures.html
Fifth figure, not labelled.

Here is a double-blind placebo controlled trial of AZT monotherapy vs combination therapy:

http://content.nejm.org/cgi/content/abstract/335/15/1081

“Conclusions Treatment with zidovudine plus didanosine, zidovudine plus zalcitabine, or didanosine alone slows the progression of HIV disease and is superior to treatment with zidovudine alone. Antiretroviral therapy can improve survival in patients with 200 to 500 CD4 cells per cubic millimeter.”

I’m sure we can dig up combination versus, combination plus protease inhibitor if we look. If you don’t know how it’s going to turn out, take a look at figure two here for a hint:

http://momentofscience.blogspot.com/2006/08/figures.html

“As long as a placebo group was not included, the results of the study are extremely limited and quite invalidated.”

Hardly. That study is very powerful evidence. Not as powerful as a randomized double-blind placebo controlled trial, but it’s still very strong evidence. Then add the fact that we have tested AZT vs nothing, AZT + another nucleoside analog vs. AZT alone, AZT + nucleoside analog#2 + protease inhibitor,... And we get to one of the places where the HIV/AIDS “rethinker” position goes from a case of extremely high skepticism to one of simple denial, in my opinion.

If we test A vs B and B is better, then we test B vs C, C vs D, and D vs E. Then after all that E is better than B how can we believe anything other than that E is better than A?

Pharma Bawd

Lise,

I meant the data was collected (by others) well before I became interested.

“but to stake your soul on an article that's co-authored by Loveless and Fuhrer. Doesn't that chill you a bit??”

Hah! Hadn’t noticed that. Good thing I’m not staking my soul on it, just citing it as evidence. How about Palella and Holmberg, it sounds a bit more innocuous.

noreen martin

I would have to respectfully disagree with you about the viral load, when in fact, it is an antibody load. My antibody load is over 100,000 right now and has been so for months. My CD4's were last known to be 191. How do you equate no clinical symptoms and great health to death?

noreen martin

Even if HIV caused Aids, which I don't believe, it's not some viral load which causes death, but OI's. Come to think about it, this could apply to other diseases or to those with weakened immunity.

noreen martin

I am amazed why doctors don't look at the big picture when it comes to Aids. Take me for example, I was sick and dying, had low CD4's and over 100,000 viral load. Look now, healthy, low CD'4s and over 100,000 viral load. I believe that a logical person would question all of this and ask, what is wrong with this picture? This doesn't add up!

Pharma Bawd

Gene,

I'm a little lost here. Hank lied about what the Lancet study found. I'm not sure which study I cited, you're talking about.

The Lancet study (subject of Hank's post) says nothing about life expectancy.

The study was simply looking at whether continued improvements to HAART like a single dose instead of three, one pill instead of a handful, better management of side effects, less toxic drugs, better adherence to drug schedules,... have led to better outcomes.

The answer is that they did in terms of viral load and CD4 cell counts, but that it did not further reduce mortality and progression to AIDS during the first year of HAART. HAART does reduce mortality and the rate of progression to AIDS during the first year of therapy. But over the past ten years tweaking the program hasn't led to further reductions in first year mortality and rate of progression to AIDS.

Hank lied. He probably didn't read the paper.

He'll neither correct, nor defend what he's written.

Why would you trust anything the man says?

Pharma Bawd

Noreen,

It's a viral load not an antibody load.

I'm not an MD, so I'm really not comfortable discussing your personal health situation, but, are there circumstances under which you would consider taking anti-retrovirals and/or protease inhibitors again?

noreen martin

Pharma Bawd, I think that you should read about the so called viral load on Virusmyth.com, Alberta Reappraisers or read "What If everything you thought you knew about Aids was wrong".

To answer your question, yes, but I would only consider these drugs if I were in the sick and dying boat again. However, with good life-style habits, I don't plan to go there again.

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