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Atripla and HSP supplementation?
May 8, 2009

Dr. Henry, I have been on Atripla (or multiple components of) for three years. My viral load has consistently been undetectable and my CD4 has never really gotten above 300.

About 8 months ago I started supplementing with heat shock proteins now the supplement is gaining momentum in the bodybuilding supplementation industry and anti-aging supplement industry. The HSP product I take is a special extract made from a pharmaceutical research company made from optina ficus indica or prickly pear.

Over the last 8 months my viral load has remained undetectable and my CD4s has climbed to 700. When I see my doctor he has no answer for it other than oh the Atripla must be finally doing its job. I dont want to seem crazy to him by telling him what I am doing. I am scared if I take this product away from my regimen my CD4s will drop again. Do you think he is right and this is just a placebo effect? I did want to add I have had issues with muscle wasting and my weight is finally stable. I also have no idea about the long term safety of what I am doing.

There have been many medical abstracts concerning HSP 70 and HSP 27 in curtailing HIV viral replication and bind and neutralize HIV VPR. I read your biographical footnote that you are very involved in the pharmaceutical and research industry. Please let me know what you think. I am too scared to stop and too scared to tell my doctor.

Response from Dr. Henry

The literature on heat shock proteins and HIV is focused on laboratory studies-no decent clinical data exists on using OTC formulations regarding safety and efficacy so I cannot comment on whether any effect might be seen. I would certainly inform your HIV doc about your use of those products. Holding the HSP formulations for several blood draws and observing CD4 count/% trends would be one way to possibly sort out (and then restarting if a consistent significant drop is seen). Even if a product with a novel mechanism of action boosts CD4 counts it is tough to know whether there is an actual clinical benefit without results from a clinical endpoint trial (as seen in the recently IL-2 trials which showed a CD4 benefit without any clinical benefit). KH



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