Hey Doctor Cohen,

I need to pick that wonderful brain of yours again. I've been doing Remune & HAART for two and one half years now. I've read a recently released Phase II trial study briefing from Spain and I'm wondering if I should continue taking the Remune injections. The briefing seemed to indicate no benefit from Remune with HAART and I read a similar report from UCSF over a year ago. In each case Immnune Response Coporation has responded with a much different spin on the trial data. I'm not sure what to think at this point. Have you read the data from the trials in Spain and if so do you have any advise for me. I have to drive from Atlanta to Columbia, SC every three months to get the injection. It's 4 hrs over and 4 hrs back and 50.00 each time. The injection causes my VL to blip from around 150 to 250 for a couple weeks after each injection and then it drops back to below 50. Your thoughts? I know your site is sponsored by major drug companies and I know Aguron owns IRC but I hope you can still give and answer. Thanks for your help.

Atlanta

Hey Atlanta.

Sure - we can speak freely. Those who sponsor the site have no control or editing of what we write - we just type and post.

As for Remune - it is hard to know what to do at this point for you - given what you have written. Nonetheless there is new research going on here in the Boston area that is among the few leads to support that Remune is in fact active and still might have an impact in how the immune system reacts. While the initial and large studies did not see any evidence of benefit - it is possible there are some benefits that were not picked up yet. For example, in the exciting work done on structured treatment interruptions, there is ongoing work to help define what we can do to make an interruption even more successful - including pretreatment with vaccinations such as Remune. In other words, if your immune system is "rehearsing" with Remune, will it be better able to control your own HIV? The very low readings in viral load you note are not worrisome - and in fact may help contribute to ultimately "training" your T cells to control HIV. Perhaps in the next few years we will learn how to use Remune, or other vaccinations, in a way that permits some time off meds - with an effective immune response helping to control HIV itself.

Maybe. Of course, Remune may not work, or not work for many, or only for a few even. And it may be that the dosing is not right. And so on. So if your ongoing study is worth the drive and the time, it is not yet possible to say. A few hours every once in a while, in a hopefully air conditioned car (given a summer in the South), with a CD on loud, singing your favorite tunes, whether it be Nat King Cole, Barbra, NSync, or Matchbox 20, may be a reasonable investment of time to see if this stuff can work. It may not, but we just don't know yet. So the research continues...

Indeed, there still is a large trial for those starting on their first treatment, where half also get Remune, while half don't (they get a placebo). And we in Boston and others are still enrolling - since there is still a chance that this may help. And we don't need to stop yet - there is much potential good that may yet be learned.

Hope that helps.