Important note: Information in this article was accurate in 2007. The state of the art may have changed since the publication date. Q. I am newly diagnosed but I have personally met two long term survivors who had epilepsy and were taking valproic acid, perhaps this is what made them survive 25 years where others died...? What is your opinion why are we not taking this now?
A. Sorry that you have had the diagnosis, but sounds like you are pushing on, and certainly reading. Learning, and being an informed patient is the best strategy for living well with HIV. Not knowing anything about your general health or laboratory values, it is difficult to advise on treatment. The success of highly active anti-retroviral therapy [HAART] is amazing, and if you're thinking about starting therapy, I'd focus on that for practical purposes, but the subjects you bring up are interesting from a research standpoint.
Let me address each of these concerns separately....
A. Valproic acid has been looked at as a way to flush virus out of "hiding" places, where anti-retroviral medications don't reach. I am not aware of it having specific anti-HIV activity. I don't think much success has been had with this agent, so far. It would be interesting to know if your friends are taking anti-HIV medications. True "elite controllers," who remain healthy without therapy and with normal T cell counts are quite rare.
Q. Some studies about gut harboring active HIV even during HAART, suggest anti- inflammatory agents. And since many other studies talk about the oxidation stress on the gut by even low level HIV replication, as well as the chronic inflamation, would it not be wise for HIV HAART people to take an aspirin or ibuprofin per day now? Isn't there enough evidence?
A. There are interesting speculations about controlling inflammation, but I know of no evidence to suggest that taking non-steroidal anti-inflammatory agents like aspirin or ibuprophen have any significant impact on HIV disease.
Q. Is HIV dozens of times more active in the gut than in the blood? What treatments are possible for the chronic inflamation of gut mucosal tissue that is infected even on HAART?
A. The gut has abundant lymphoid tissue, and this is one of the largest reservoirs of HIV in the body. Treatments focused on this store of virus could be very useful.
Q. In the late 80s and early 90s many HIV [positive] people used steriods to some short term benefit, is this not strong evidence that the steroids have a place today in helping HIV even on HAART. What kind of steroids are they talking about? Should we all be on some kind of steroid?
A.Before HAART, many patients were put on anabolic steroids, drugs that mimic the activity of male hormones. There was some evidence, not overwhelming, that this improved patient health. Post HAART, I know of no studies to suggest benefit from these agents.
Q. Emerin - a potential new class of meds being studied (stops wasting?) where can I get in on this study??
A.I am not familiar with this drug. Are you wasting? This would be unusual in a newly diagnosed patient.
Q. Anti-CD30 antibody exerts suppression on HIV replication, but what do we do when a research company has a breakthru that could help HIV but they are focusing on cancer? Could this antibody save people without so many side effects?
A.If a drug company has a drug that is useful for HIV, they have every
reason to research and market it for that indication. I doubt that
this antibody could replace the amazing benefits of HAART.
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