Hiv Support

[jbaldwin]

My girlfriend has tested positive for HIV. She would not take a second test to confirm the result and has gone home to stay with her parents. Does anyone know where we can go for help/information either in Pattaya or at her home in Bruiram? What is the cost of Anti-Retoviral trestment in Thailand and could she get any help if she could not afford them

[Sing_Sling]

Have you had yourself tested?

[Guest IT Manager]

Contact me by PM. I use MSN messenger as well which makes it easy to work through some of the issues you and her if you are planning to hang about will face.

Good luck. Also Sing Slings question made sense.

[jbaldwin]

Yes I have had a test which was negative but I will retest in a couple of months just to check

[Pink Mist]

JB take IT's advice and PM him, he will prove very helpfull to you.

[eric1000]

My girlfriend has tested positive for HIV. She would not take a second test to confirm the result and has gone home to stay with her parents. Does anyone know where we can go for help/information either in Pattaya or at her home in Bruiram? What is the cost of Anti-Retoviral trestment in Thailand and could she get any help if she could not afford them

you really need to go to a major hospital in Bangkok for proper advice on when to start treatment . buriram or pattaya is not the place to go to.

the university hospital in Khon Kaen is very good for HIV infected folks.

blood tests to check Cd4 levels first then start some treatment when they reach a critical point . this could take years to happen.

then take blood tests every 3-6 months .

HAART only needs to start when needed due to Cd4 counts . drugs are likely to be offered free next year according to thaksin . who will get them remains to be seen .prices are falling as the drugs will be made in thailand -

usually a person would take 3 drugs daily - AZT + 2 others.

diet is also very important . cut out booze and bad habits

so long as she takes the daily drugs things look promising .

[Guest IT Manager]

My girlfriend has tested positive for HIV.  She would not take a second test to confirm the result and has gone home to stay with her parents.  Does anyone know where we can go for help/information either in Pattaya or at her home in Bruiram?  What is the cost of Anti-Retoviral trestment in Thailand and could she get any help if she could not afford them

you really need to go to a major hospital in Bangkok for proper advice on when to start treatment . buriram or pattaya is not the place to go to.

the university hospital in Khon Kaen is very good for HIV infected folks.

blood tests to check Cd4 levels first then start some treatment when they reach a critical point . this could take years to happen.

then take blood tests every 3-6 months .

HAART only needs to start when needed due to Cd4 counts . drugs are likely to be offered free next year according to thaksin . who will get them remains to be seen .prices are falling as the drugs will be made in thailand -

usually a person would take 3 drugs daily - AZT + 2 others.

diet is also very important . cut out booze and bad habits

so long as she takes the daily drugs things look promising .

Eric, this is Asia. That is wrong. Totally and utterly incorrect. Sorry. Please don't give advice that you aren't sure of.

AZT, dDI HAART does not work all the time with type E. The current view is a 30-45 % success with it. Also it is hideously expensive compared to other options.

Sorry to be a pain. Others on the forum will tell you, I have a basic idea of what I am talking about. In Thailand.

[eric1000]

the university hospital in Khon Kaen is very good for HIV infected folks.

blood tests to check Cd4 levels first then start some treatment when they reach a critical point . this could take years to happen.

then take blood tests every 3-6 months .

HAART only needs to start when needed due to Cd4 counts . drugs are likely to be offered free next year according to thaksin . who will get them remains to be seen .prices are falling as the drugs will be made in thailand -

usually a person would take 3 drugs daily - AZT + 2 others.

diet is also very important . cut out booze and bad habits

so long as she takes the daily drugs things look promising .

Eric, this is Asia. That is wrong. Totally and utterly incorrect. Sorry. Please don't give advice that you aren't sure of.

AZT, dDI HAART does not work all the time with type E. The current view is a 30-45 % success with it. Also it is hideously expensive compared to other options.

Sorry to be a pain. Others on the forum will tell you, I have a basic idea of what I am talking about. In Thailand.

whats totally wrong ? please elucidate

i know infected thais who would like to know whats cheaper than AZT and DDI medication . thats what they are on right now.

the docs at khon Kaen told me that more than 90% of HIV infected local patients cant afford any kind of medication so i would like to know what is cheaper than AZT and DDI .

i am willing to listen to your sage advice because peoples lives depend on it !

[samuisam]

here is one-

Wednesday Friends Club

Hotlines 02-255-7893, 02-255-7894.

E-mail: [email protected]

Support and social organization for people living with HIV/AIDS. This organization has chapters throughout the Kingdom and will provide extensive contact and resource information on treatments.

Here is a list of resources -

http://www.floatinglotus.com/aidsthai.html#Wednesday

Peace,

sam

[The_Moog]

Same thing happened to me in 1999, I offered the meds to an ex-girlfriend who was diagnosed HIV+.

She chose to go back to the Thai guy whom she'd originally left me for, and who then infected her (he already knew he was infected when he gave it to her).

I don't think she'd have had the self-discipline to adhere to the rigorous regimen of pill-taking, but I still offered them to her. She'd have probably split them with the Thai man - (and I believe that mis-dosing can make things worse), or just ask for the money...

..in fact that's what they did do, ask for the money.

If I had started providing the medicine, then I would have been on the hook permanently. (One can't simply say, 'oh i'm stopping them now', after a year)

Ultimately I chose not to take responsibility for something that - well, really wasn't my responsibility.

[randyksf]

Few things

This matter that is personal and scary as ######. Please don't say things that you heard about from a friend or the information is years old.. You do more harm than good.

I ask you to share your experience, but not give any medical advice unless you are trained or a Dr. that specializes in HIV or internal medicine. Sorry an Orthopedic or a dermatologist have little knowledge of this topic.

Things are changing everyday and treatments are different for everyone.

All gave some good advice but the best advice was to talk to the professionals or support lines.

If you are currently living with it or your partner is. Then send an off-line msg saying you are willing to help. Having friends to talk to can make all the difference in the world. Or even better share your expenses with everyone.

Also people keep talking about HIV. What about the other STD's like Hep A, B, C and now G?

After reading some of the posts, and not only from this tread, scares the ###### out of people. Just imagine when you read something then someone else corrects them. It will confuse people even more.

[randyksf]

Now that I have ranted about miss information

Here are some solid questions that might make difference to some people. People should be tested every 6 months. Regardless of sexual activity it has been proven by studies people who get regular testing are less likely to contract HIV. (that was told to me by and HIV test place in SF)

1. Where can you get tested? For both HIV and other STD?

2. Can you get home kits?

3. If you do test positive as an falang will you be black listed?

4. What medical services can you expect here?

5. How backwards are the treatments vs. the US, UK or any other western country?s?

6. Other than the obvious health issues are there any other repercussions living here with HIV or with a partner with HIV that you need to be aware of.

One other thing I must say. (this is something I had to deal with personally. )

Most of the symptoms of HIV/AIDES can be caused from other factors such as stress and other little bugs. We pick up.

Stress can cause Diarrhea, night sweats, in some cased depending how much stress you can get feavor too.

Getting tested can really take away a lot of stress. I know because I had all the those symptoms, at one point in my life. After getting all the tests the Doctor told me to take a week or two off from work and relax.

The funny thing was as soon as I knew what was going on I felt much better.

So get tested and know. Not knowing is ten times worse than having it and dealing with it.

Back in San Francisco I had tow roommates that have been living with HIV for 10 plus years. One takes meds the other smokes a joint and is fine.

[Guest IT Manager]

the university hospital in Khon Kaen is very good for HIV infected folks.

blood tests to check Cd4 levels first then start some treatment when they reach a critical point . this could take years to happen.

then take blood tests every 3-6 months .

HAART only needs to start when needed due to Cd4 counts . drugs are likely to be offered free next year according to thaksin . who will get them remains to be seen .prices are falling as the drugs will be made in thailand -

usually a person would take 3 drugs daily - AZT + 2 others.

diet is also very important . cut out booze and bad habits

so long as she takes the daily drugs things look promising .

Eric, this is Asia. That is wrong. Totally and utterly incorrect. Sorry. Please don't give advice that you aren't sure of.

AZT, dDI HAART does not work all the time with type E. The current view is a 30-45 % success with it. Also it is hideously expensive compared to other options.

Sorry to be a pain. Others on the forum will tell you, I have a basic idea of what I am talking about. In Thailand.

whats totally wrong ? please elucidate

i know infected thais who would like to know whats cheaper than AZT and DDI medication . thats what they are on right now.

the docs at khon Kaen told me that more than 90% of HIV infected local patients cant afford any kind of medication so i would like to know what is cheaper than AZT and DDI .

i am willing to listen to your sage advice because peoples lives depend on it !

GPOvir. 1350 Baht per month. 70% new user acceptance, includes AZT, dDi and Nelfinovir.

Second level HAARTS acceptability exceeds 80 %. That means when you change your HAARTS group, you have better than 80% chance of no contra-indications.

It is available from many private clinics, is produced by the Government Pharm. Org, hence the name. Hospitals have it available under the 30 baht scheme but many are running/have run out of funds to buy/supply. However, if our concerned friend were to go to the hospital and offer to pay, they will happily sell it to his lady. If it is more than 1,350, he can contact me direct for the location of a provider.

Re listening to my sage advice, regarding peoples lives, try this.

OK mai?

[Guest IT Manager]

Rebuilt below

Now that I have ranted about miss information

Here are some solid questions that might make difference to some people. People should be tested every 6 months. Regardless of sexual activity it has been proven by studies people who get regular testing are less likely to contract HIV. (that was told to me by and HIV test place in SF)

1. Where can you get tested? For both HIV and other STD?

+++ Answer, any hospital and many privatedoctor clinics. In CM go to Dr Narong here

2. Can you get home kits?

+++ Yes but there have been questions about their benefits. Find out alone as opposed to being told by a practitioner. Most clinics who manage STD's have the kits for use by a doctor, which is on the spot.

3. If you do test positive as an falang will you be black listed?

+++ Not that I have heard, as there is no requirement to report, though public hospitals testing pre-natal mothers do report test results anonymously, in larger hospitals. This is where the information for Thailand's AIDS level comes from and why many people view it as inaccurate.

4. What medical services can you expect here?

+++ Whatever you can afford. If you have little money, a private clinic advising and prescribing GPOvir will work and it will be cheaper than at home.

5. How backwards are the treatments vs. the US, UK or any other western country?s?

+++ Thailand thanks to Senator Meechai (cabbages and condoms) instituted a very large education program in the early nineties. Most Thai kids are aware of safe sex issues. Many prostitutes also.

+++ Remember that many (not all) of the organisations involved in HIV/AIDS were begun by foreigners using O/S AID systems such as AUSAID and USAID. UNAIDS has been very active in training medical people to educate as well as manage. The available services are well in place, and well used.

+++ Laurie Maund, an Aussie at Wat Chedi Luang in CM has done sterling work educating monks from villages to interact with local people who have the virus. In my village, my son is not stigmatised. Not all know, but the ones who must know, do. This is true in many villages where populations of PLWA's are found, and their efforts to self-support are assisted by many other villagers. Bear in mind that every person living with the virus has a family, and there appear to be far less kids thrown out of home for being gay, ergo, they don't have to join the street kids selling their bodies and hitting up smack, to survive.

+++ GPOvir is easily maintained since it is only 2 tablets per day for the HAARTS plus whatever vitamin support you use. My son uses 5 different vitamin groups and he is now on another natural medication, thanks to P1P.

6. Other than the obvious health issues are there any other repercussions living here with HIV or with a partner with HIV that you need to be aware of.

+++ Thats a good question. If you are aware of any side effects/contra indications of your HAARTS regime, no there shouldn't be.

+++ Lifestyle issues here make the emotional side issues less confronting in my opinion. My sons' health is quite manageable from a side effect point of view, and he self administers his second daily dose. For information, some years ago we had a big argument, when he was about 13. He ran away from home. When I found out, I checked the refrigerator. He had taken his meds with him in his day manager (pill tray). He came home the following Saturday night, gave me a hug and handed me his pill tray for re-stocking. We haven't argued since.

One other thing I must say. (this is something I had to deal with personally. )

Most of the symptoms of HIV/AIDES can be caused from other factors such as stress and other little bugs. We pick up.

Stress can cause Diarrhea, night sweats, in some cased depending how much stress you can get fever too.

Getting tested can really take away a lot of stress. I know because I had all the those symptoms, at one point in my life. After getting all the tests the Doctor told me to take a week or two off from work and relax.

The funny thing was as soon as I knew what was going on I felt much better.

So get tested and know. Not knowing is ten times worse than having it and dealing with it.

+++ Very very good points. There are sure-fire signs as well as gueessometric indicators. The sure fire signs are there to be seen if you know what you are looking AT not FOR. If you are sexually active, get tested minimum twice a year. If not, once is probably OK. If you don't use condoms when you have sex, and you haven't known the person for over a year, you are foolish in the extreme.

+++ Even though transmission female to male is harder than male to male or male to female, it does happen, (prostitutes passing on the virus to their male clients), and if you don't take good genito/sexual care of yourself, you run a higher risk.

Back in San Francisco I had tow roommates that have been living with HIV for 10 plus years. One takes meds the other smokes a joint and is fine.

+++ My son is a 6.5 year survivor. I am very very proud of him.

[eric1000]

the university hospital in Eric, this is Asia. That is wrong. Totally and utterly incorrect. Sorry. Please don't give advice that you aren't sure of.

AZT, dDI HAART does not work all the time with type E. The current view is a 30-45 % success with it. Also it is hideously expensive compared to other options.

Sorry to be a pain. Others on the forum will tell you, I have a basic idea of what I am talking about. In Thailand.

whats totally wrong ? please elucidate

i know infected thais who would like to know whats cheaper than AZT and DDI medication . thats what they are on right now.

the docs at khon Kaen told me that more than 90% of HIV infected local patients cant afford any kind of medication so i would like to know what is cheaper than AZT and DDI .

i am willing to listen to your sage advice because peoples lives depend on it !

GPOvir. 1350 Baht per month. 70% new user acceptance, includes AZT, dDi and Nelfinovir.

Second level HAARTS acceptability exceeds 80 %. That means when you change your HAARTS group, you have better than 80% chance of no contra-indications.

It is available from many private clinics, is produced by the Government Pharm. Org, hence the name. Hospitals have it available under the 30 baht scheme but many are running/have run out of funds to buy/supply. However, if our concerned friend were to go to the hospital and offer to pay, they will happily sell it to his lady. If it is more than 1,350, he can contact me direct for the location of a provider.

Re listening to my sage advice, regarding peoples lives, try this.

OK mai?

you forgot one thing cleverclogs , you dont mention as i did that nobody needs to take any medication until their cd4 count warrents it.

thus you dont need to spend any money on uneccesary drugs until its really needed.

this could take years to happen ,so blood analysis is important above all

and getting registered at the right place so follow up can take place is important.

[eric1000]

Sorry to be a pain. Others on the forum will tell you, I have a basic idea of what I am talking about. In Thailand.

HAART and CD4 count Updated:

CD4 counts in the age of HAART

While viral load and CD4 count are both predictors of disease progression in untreated populations, there is evidence that CD4 response on treatment is a better predictor of clinical outcome than viral load among people receiving highly active antiretroviral therapy (HAART). In addition, CD4 count prior to treatment is crucial to response to treatment. That is, if you start treatment with a CD4 count below 200, you are more likely to experience deteriorating health than if you start treatment when your CD4 count is above 200.

CD4 count and response to treatment

The link between baseline CD4 count and response to treatment - in terms of viral load and clinical status - is now well established.

Numerous studies have found that risk of disease progression is reduced among people who start HAART when their CD4 count is above 200. However, current evidence indicates there is no clinical (health) benefit to starting treatment with a CD4 count above 350. Individuals who start treatment with a very low CD4 count (below 200) are more likely to experience disease progression than people who start treatment earlier. The predictor value of CD4 counts prior to therapy is used as the basis for guidelines concerning when to start therapy.

[eric1000]

My girlfriend has tested positive for HIV. She would not take

Posted on Mon, Dec. 22, 2003

Living longer with HIV

By Charlotte Huff

Special to the Star-Telegram

Ray Moore

As new drugs extend the life span of patients, the medical community re-evaluates their needs

Martin Lane has been living with HIV for 10 years, but it's not his leading health concern. Thanks to the sophisticated AIDS drugs that emerged in the mid-1990s, the life-threatening virus in Martin's blood has been reduced to undetectable levels, or nearly so, in recent years.

"I don't think it's going to kill me," said Lane, 48, of Granbury. "I think it's the heart that's going to kill me, more than anything."

Lane had a heart attack three years ago, abruptly becoming flushed and nauseated one morning, unwilling to consider the worst until pain ran down his left arm. He underwent an angioplasty, clearing two of his clogged arteries. Lane blames his family history; his father had suffered a fatal heart attack just a few months before.

As people with HIV live longer, moving into their 30s, 40s and 50s, doctors say that additional health problems are arising, including arthritis, hip pain and strokes.

Sometimes the health problems may be related to the drugs. Although findings are still mixed, researchers are increasingly concerned about the tendency of some AIDS drugs to raise cholesterol and triglycerides, potentially boosting heart-attack risk. Breakdown of bone composition, generally in the hips, also is a potential drug-related concern.

As with heart worries, it's not clear if the bone changes are linked to the drugs, the virus itself or other factors, such as the patient's genetics, said Dr. Daniel Skiest, associate chief of infectious diseases at the University of Texas Southwestern Medical Center at Dallas. Several of Skiest's patients have required hip-replacement surgery.

Other problems are more of a garden-variety sort, related more to the individual's increasing age, such as cataract or hernia surgeries. Neither does it help that some people with HIV have practiced a live-in-the-moment lifestyle for years -- and some persist. Dr. Elvin Adams, who oversees HIV treatment at the Tarrant County Public Health Department, estimates that as many as 80 percent of his patients smoke.

"I say, 'Now that you are not going to die of HIV/AIDS, you need to think about what you are really going to die of,' " Adams said.

What about transplants?

Dr. Roberto Arduino, who works full time at the Houston public hospital system's HIV clinic, recalls the days when death lists were issued each week listing the names of those who had succumbed. Now he struggles to recall more than three people out of his nearly 800-patient load who have succumbed to the virus in the previous six months.

In Adams' practice of 600 patients, usually three to five people die each year of AIDS -- roughly the number who die of smoking-related cancers. Usually, Adams says, it's because they weren't keeping up with their complicated regimen of medications. Prospects for those newly found to have the virus are good, he said.

"In terms of their HIV and AIDS, I tell them they can recover normal immune function," he said. "That they can live for an undetermined period of time."

In the past several years, Adams' patients have undergone a variety of procedures, including cataract removal, back surgery and hernia repair, that previously would not have been considered essential.

"People are doing well enough now that all kinds of conditions come out of the woodwork that need to be addressed," he said. "If you have advanced AIDS, why should you have a cataract taken out?"

Across the country, improved HIV survival also is raising a sticky ethical question for transplant centers. As more people with HIV bring their virus under control, should they be prevented from receiving lifesaving transplants?

People who get organs often have other serious underlying health conditions, such as diabetes or high blood pressure, said Dr. Michelle Roland, assistant professor of medicine at University of California, San Francisco, and one of the leading researchers in this area.

"Prior to antiretroviral [HIV] therapy, it didn't make sense to allocate a scarce resource to a group of people who weren't going to benefit from it," Roland said. "That's simply not the case anymore."

Living to see old age

To survive, though, people with HIV often have to take numerous medications a day, some of which can trigger debilitating side effects, including severe diarrhea and nausea. Depending upon the patient and the drugs involved, the so-called AIDS cocktail -- generally a combination of daily drugs -- also can dramatically boost lipids.

It's not uncommon for Adams to see triglyceride readings top 2,000, far above the ideal threshold of 150. And starting a lipid-lowering medication doesn't always help, he said.

There is accumulating evidence that some drugs may increase the risk of heart problems, ranging from clogged arteries to heart attacks, said Skiest. The Dallas physician pointed to a study published in the November issue of The New England Journal of Medicine, which found that the risk of heart attacks increased 26 percent for every year that people continued on the drugs. Still, he stressed, the life-extending benefits of the AIDS drugs far outweigh any potential heart risk.

Les Dennis had a series of strokes before his HIV diagnosis in 2002. But he doesn't think the AIDS drugs have helped matters. Since starting them, he's gone to the hospital twice with severe chest pain and is now temporarily off the drugs under a doctor's supervision.

"Yes, these medications are wonderful," said Dennis, a licensed vocational nurse, 56, of Fort Worth. "But the problem we face is we are taking medication that's very toxic. They tell you -- it can affect your liver, it can affect your kidneys."

Dennis has made some lifestyle changes since his diagnosis, reducing his fast-food habits and eating more fruits and vegetables.

But bad habits are hard to break.

Ray Moore, whose HIV was diagnosed six years ago, has tried numerous times to kick his smoking habit, including eight rounds of hypnosis. "I've worn the patches. I've chewed the gum," he said.

Several months ago, Moore gave up trying to quit smoking and started making efforts to exercise more. Mostly, he acknowledges that he's still getting adjusted to his new life view -- one without any definite horizon.

When his HIV was diagnosed at age 50, Moore never expected to leave the hospital. Two years ago, he was consuming more than four dozen pills every 24 hours and thought every day would be his last.

"Now my doctor tells me I'm going to live to be an old man," said Moore, chairman of Positive Voices, a consumer group for people with HIV in North Central Texas. "The big cliche is, 'What am I going to do for the rest of my life?' Because I think I've got one -- and I didn't expect that."

Making the cut for transplants

More than five years ago, California physician Michelle Roland was finishing her residency training in internal medicine when she met a patient with HIV who was dying of liver failure.

"It was clear that the transplant center at that time was not interested in evaluating her," said Roland, now an HIV specialist and assistant professor of medicine at University of California, San Francisco.

In the years since, Roland has joined other HIV specialists nationwide in arguing that people with controlled disease -- often to the point that their virus is undetectable based on tests -- shouldn't be denied access to an organ transplant. Roland is quick to say that she doesn't blame transplant surgeons. They simply weren't aware of the dramatically improved survival prospects for people with HIV, she says, and even raising the issue has sparked some change.

Several years ago, only a handful of centers, including University of California, San Francisco, would perform any transplant on an HIV-positive patient. Now Roland is co-investigator of a National Institutes of Health-funded study that will examine liver and kidney transplants in 275 people at 16 U.S. transplant centers. More centers wanted to join, but the funding wouldn't permit it, Roland said.

Roland and some other HIV specialists argue that as people live longer with the virus, the need for transplants will increase dramatically. People with HIV are often also infected with hepatitis C, a disease that over decades can cause liver failure. The virus itself also can cause kidney damage and potentially failure over the long haul.

"My position is that patients can be controlled with HIV and should be treated as HIV-negative," said Dr. Roberto Arduino, associate professor of medicine at University of Texas Health Science Center at Houston. "If they need organ transplantation, they should have access to the procedure."

The medical issues involved are multifaceted, including whether the transplant and related drugs aggravate the individual's HIV, as well as the overall transplant success in someone with HIV compared with people not infected with the virus.

LifeGift spokeswoman Catherine Burch Graham said that she's not aware of any transplants performed on people with HIV at the medical centers served by the organ bank, including hospitals in Houston and at Harris Methodist Fort Worth. Neither has that step been taken by the transplant programs at Baylor Health Care System, said Dr. Marlon Levy, surgical director of transplantation at Baylor All Saints Medical Center in Fort Worth.

"If the [research] data truly support this, I'm sure we and the rest of the transplant community will come along and do this," Levy said. But at this point, he said, "the transplant process is such an agony for patients waiting for organs, many dying for lack of organs, why would we broaden the potential pool of recipients?"

-- Charlotte Huff

The path of HIV

• More than 800,000 U.S. residents are HIV-positive; an additional 40,000-some cases are diagnosed annually.

• Seventy percent of HIV diagnoses occur in men. African-Americans are the hardest-hit racial group, comprising more than half of all new cases.

• HIV refers to the virus that causes AIDS. But due to a sophisticated arsenal of drugs, people found to have HIV don't necessarily become sick enough to progress to full-blown AIDS.

• The drugs, which appeared in the mid-1990s, are sometimes called the AIDS "cocktail" because they usually include several drug classes taken in combination. Although the side effects can be significant -- among them severe nausea and diarrhea -- the drugs are extending life spans dramatically.

-- Charlotte Huff

Source: National Centers for Disease Control and Prevention

[Guest IT Manager]

Thanks Eric. I didn't feel it appropriate to post the January minutes in here, but appreciate it none the less.

The biggest area of misinformation is big hospitals, big money. Not right at all. There was my view. Still is.

At what point should this forum become a medical advisory? In my opinion, never, but never also should it be a disinformation organisation.

Hope that clears my points up. Keep it simple for a start. If someone is diagnosed, then they come in with PM to several of us, me included, for support. The bits you see in forum are only the tip of an iceberg I can assure you.

Thank you for your input immensely. It is good to welcome you to Thaivisa.com

######

[eric1000]

Host Genotype Plays Important Role in Childhood HIV Progression

In children, CCR5 genotype and other host genetic factors play an important role in HIV-related disease progression and neurological impairment, according to a report in the November 15th issue of The Journal of Infectious Diseases.

Numerous host genetic factors have an impact on both the susceptibility to HIV infection and the rate of progression to AIDS and death, the authors explain.

Dr. Stephen A. Spector from University of California, San Diego, La Jolla, California and colleagues evaluated the effects of polymorphisms in CCR2, CCR5, and SDF1 on the rate of disease progression and neurological impairment in 1049 children with symptomatic HIV-1 infection.

Children with the CCR5-delta32 allele, previously linked to protection from HIV infection, had higher mean CD4 lymphocyte counts and percentages, lower mean HIV-1 RNA levels, and higher mean cognitive-index scores than did children not bearing this allele, the authors report.

Among children homozygous for wild-type CCR5, mean lymphocyte percentages and mean cognitive-index scores were higher in those with the CCR5-59353-C/C and mean lymphocyte percentages were higher with the CCR5-59356-T/T genotypes, the report indicates.

These polymorphisms, as well as those in CCR2, were not found to influence disease progression or the decline in neurocognitive status.

In contrast, the researchers note, the A/A genotype of SDF1-3' was associated with a doubling of the relative hazard for disease progression and with a significant increase in neurocognitive impairment associated with disease progression.

In a multivariate analysis, the CCR5-59029 genotype was the strongest single predictor of disease progression among children with wild-type CCR5.

"Specific polymorphisms in an individual child's genes can significantly impact on how that child will respond to HIV infection and be an important determinant of how rapidly their disease will progress," Dr. Spector told Reuters Health.

"At this point, children should not be tested for CCR5 polymorphisms," Dr. Spector said. "However, the time may come that combined with other tests for specific polymorphisms that this can provide useful information in making treatment decisions."

"We believe that this impact of host genetics on infectious diseases of children is not isolated to HIV but applies to most other infections," Dr. Spector added. "For example, it is not just luck that one child gets infected with measles virus and recovers in 4 days and another child gets infected with measles virus, develops encephalitis and dies. We believe that there is a predictable host-virus interaction that can be found that can predict these outcomes."

[naja]

Some questions.

Are the so-called "AIDS tests" HIV specific? If so,then why do people who have had malaria,TB,leprosy,and other bacterial, microbiological and fungal diseases test positive?

Why do dogs' sera test positive on the Western Blot test?

How come even after the expenditure of billions of dollars and the efforts of thousands of research workers, HIV has not yet been isolated.Do you know how long it took research workers to isolate and identify the SARS virus?2 weeks? 3 weeks?

Why is it that testing positive to HIV is indicative of present infection,when all other positive antibody tests[eg to rubella ] indicate past infections?

Why is it that some people who have been diagnosed as having AIDS,test HIV negative?

Has anyone ever seen a picture of HIV?

[Guest ka1234]

How come even after the expenditure of billions of dollars and the efforts of thousands of research workers, HIV has not yet been isolated.Do you know how long it took research workers to isolate and identify the SARS virus?2 weeks? 3 weeks?

...

Has anyone ever seen a picture of HIV?

Looks like you have read one of Trink's misinformation campaigns.

http://www.royalsoc.ac.uk/library/images/hivvirus.jpg

http://virology-online.com/presentations/hiv.gif

http://www.nature.com/nsu/020114/images/hiv_160.jpg

[TizMe]

Do you know how long it took research workers to isolate and identify the SARS virus?2 weeks? 3 weeks?

I have zero medical knowledge, but I would guess that SARS was easily isolated because of the very short incubation period. On the other hand HIV was already widely dispersed before anybody even knew that it existed.

On top of that HIV has mutated into a couple of different strains.

[Digger]

My girlfriend has tested positive for HIV. She would not take a second test to confirm the result and has gone home to stay with her parents. Does anyone know where we can go for help/information either in Pattaya or at her home in Bruiram? What is the cost of Anti-Retoviral trestment in Thailand and could she get any help if she could not afford them

Going back to the original question, yes there are treatment options in both Pattaya for sure and I suspect Buriram as well.

Of the private Hospitals, Bangkok Pattaya has specialist HIV doctors on staff - I do not know of any others that do.

In terms of treatment, the Govt issued drugs combo is NOT considered the most effective in almost any scenario. However, if you have no other options (i.e money) then this is certainly your best option. If you have money available, then depending upon viral load and CD4 counts most experts in Thailand will recomend waiting until CD4 level hits 200-250 range and then starting on a combination of Combivir and Stocrin. Combivir is a twice daily single tablet and Stocrin is a once a day single tablet (or 3 smaller capsules). The cost for this treatment is approx: 12-15,000 baht per month from the top private hospitals, lower from Govt clinics. These are both the 'genuine' drugs produced by the original manufacturers. Thailand has a licence to produce a copy Combivir which would drop the price considerably however there is concern that the lab poducing the copies is not at the right level of quality. This is the notional "mercedes benz" of HIV treatments currently and consistently applied in the Uk and USa. If however the patient has a very high viral load, Hep B or other complications, different strategies may be suggested.

In my opinion however the bigger problem she will face is actually coming to terms with this and doing something about it. You may suggest private healthcare as she will likely feel that she is less likely to run into someone she knows at the hospital and that the treatment will be better. Half the issue is getting into the right frame of mind to handle this now and in the future. That is where a sympathetic doctor is the best help she can get at this stage and keep undertaking regular CD4 and viral load tests (which can be very expensive at around 6,000 baht for a VL test, Cd4 is much much cheaper).

Hope this helps

[Guest IT Manager]

Thanks Digger, excellent points, including re-iteration of cd-4/8 vl counts.

Our original poster didn't mention money I don't think but the point is well made anyway. My son started HAARTS at <35 cd4 >450,000 VL. He is now stable <100K and >350 which is what we aimed for. He also started HAARTS on azt, ddI, Saquinovir, at that time costing around 38K baht per month.

We moved him over the GPOvir when it became available as he and saqunovir II softel caps were not good friends. Now he is ion excellent health, and past his 6.5 years survival point. Looking forward to February, when we celebrate his 7th year since diagnosis.

Welcome to the fray. Happy New Year, as is ours, thanks to "his nibs".

[naja]

To my last question: only 1 of the 3 images in the 3 links is of an electron micrograph,and as it stands it is meaningless as there are no labels,nor is there any scale to give any indication of the size of the objects in the micrograph.These criticisms also applies to the other images. First rule when submitting a paper for publication-always label your diagrams ;and photos of microscopic thin sections and electron micrographs should contain a scale.

To jbaldwin: What bands on the Western Blot test constitute a positive test in Thailand? 2 bands[p24 and p120? p24 and p41? p24 and p160?], 3 bands [p41,p120 and p24?...and so on]

A person who tests positive in Africa would be classed as being negative in Australia.A person who tests positive in Australia would be classed as being negative in Africa.A person who tests positive according to the CDC [uSA] would be negative according to the US Red Cross. There are no internationally agreed criteria as what constitutes a positive Western Blot test.Even different labs have their own criteria.Now coupled with this problem is the one of interpreting the bands in the gel.How dense does a band have to be to be regarded as indicating the presence of the diagnotic HIV protein?

A story: 19 subsamples of 1 serum was sent to 19 different testing labs.The 19 gels showed at least 8 different banding patterns. 3 gels showed no diagnostic bands or only 1 or 2 weakly defined bands.

A similar experiment has been done involving the ELISA test. Similar inconsistent results obtained even when aliquots of the same serum was submitted on 40 different occasions to the same reference laboratory.

I'm just as ignorant as the next person.

[Digger]

Thanks Digger, excellent points, including re-iteration of cd-4/8 vl counts.

Our original poster didn't mention money I don't think but the point is well made anyway. My son started HAARTS at <35 cd4 >450,000 VL. He is now stable <100K and >350 which is what we aimed for. He also started HAARTS on azt, ddI, Saquinovir, at that time costing around 38K baht per month.

We moved him over the GPOvir when it became available as he and saqunovir II softel caps were not good friends. Now he is ion excellent health, and past his 6.5 years survival point. Looking forward to February, when we celebrate his 7th year since diagnosis.

Welcome to the fray. Happy New Year, as is ours, thanks to "his nibs".

If I understand your VL level correctly. you say its at less than 100,000 - just out of curiosity how long has he been on current regime? Normally you would expect to get to undetectable within 6-9 months from what I understand i.e less than 50 (yes single numbers as opposed to thousands) - anything which is bordering around 100,000 after a lengthy time is considered a non effective treatment. Fantastic improvement though in CD4 count - 350 is considered well into the safe zone.

I think an excellent reference site is www.thebody.com and look at questions posed before and also have the opportunity to pose your own. Fantastic information and far easier to understand than most HIV related sites in MHO.

I think you make a very interesting observation, albeit indirectly prices. If your son started of with a treatment costing 38,000 baht or thereabouts, the newer and more effective regimes (notably Stocrin and to lesser extent nevarapine) + 3TC have really tumbled in price in Thailand. They are approx 20% of what you would pay in the west. When the Thai producer finally gets the Combivir copy right, prices will come down to approx: 6,000 baht per month for the complete treatment programme which is a major improvement and a realistic option considering that the side effects for most people are either non existent or minor irritations. It is recognised that the majority of people on these latest treatments are living full and complete lives, able to work in almost any job and living life to the full with forcast life expectancy near to a normal person.

Im sure you are rightly proud of his achievements.

[Guest IT Manager]

Thanks Digger, excellent points, including re-iteration of cd-4/8  vl counts.

Our original poster didn't mention money I don't think but the point is well made anyway. My son started HAARTS at <35 cd4 >450,000 VL. He is now stable <100K and >350 which is what we aimed for. He also started HAARTS on azt, ddI, Saquinovir, at that time costing around 38K baht per month.

We moved him over the GPOvir when it became available as he and saqunovir II softel caps were not good friends. Now he is ion excellent health, and past his 6.5 years survival point. Looking forward to February, when we celebrate his 7th year since diagnosis.

Welcome to the fray. Happy New Year, as is ours, thanks to "his nibs".

If I understand your VL level correctly. you say its at less than 100,000 - just out of curiosity how long has he been on current regime? Normally you would expect to get to undetectable within 6-9 months from what I understand i.e less than 50 (yes single numbers as opposed to thousands) - anything which is bordering around 100,000 after a lengthy time is considered a non effective treatment. Fantastic improvement though in CD4 count - 350 is considered well into the safe zone.

I think an excellent reference site is www.thebody.com and look at questions posed before and also have the opportunity to pose your own. Fantastic information and far easier to understand than most HIV related sites in MHO.

I think you make a very interesting observation, albeit indirectly prices. If your son started of with a treatment costing 38,000 baht or thereabouts, the newer and more effective regimes (notably Stocrin and to lesser extent nevarapine) + 3TC have really tumbled in price in Thailand. They are approx 20% of what you would pay in the west. When the Thai producer finally gets the Combivir copy right, prices will come down to approx: 6,000 baht per month for the complete treatment programme which is a major improvement and a realistic option considering that the side effects for most people are either non existent or minor irritations. It is recognised that the majority of people on these latest treatments are living full and complete lives, able to work in almost any job and living life to the full with forcast life expectancy near to a normal person.

Im sure you are rightly proud of his achievements.

Thank you. Very Proud of him.

[markoinbangkok]

Hmmm... Am I the only one who thinks something here is amiss?

My girlfriend proved positive for HIV...

Did you actually see the report or speak to the examiner?

How did your girlfriend get it?

What inspired her to even get tested?

Hmmm...

[Guest IT Manager]

I don't see anything amiss. Even if the original poster was having a wind-up, there are enough people in here, as proven by the posts, for the thread to be beneficial to posters faced with the issues involved.

[leonah]

Once tested positive... do you really want to take the chance of 'not' getting the right medication on time at the time. The reason our son has survived as long as he has, is that his medication was started, as soon as diagnosed. The reason that one of our friends, a Thai, died so soon after diagnosis, was that medication was not administered as soon as diagnosed. Another friend, a Thai woman, lived a healthy painless life for 10 years with limited suffering until her last few months. She always wished she had started the medication when she was diagnosed, rather than later, when her bood count was too low to give her a real fighting chance.

Do you really want to take a chance?

Go see the doctors and get medical advice, then talk to those who have been through it, or are going through it.

It's your life. It's her life. Don't take the attitude that you're doomed or shes doomed. Your not, she's not. Have a Great Life, and live it!

What keeps my husband and I going is the evidence before us, our sons alive and well after 6.5 years. And we're looking forward to many, many more years with him.

For those of you who know me, sorry for venting in this forum.