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Boosting the Immune System
Apr 24, 2000

Dr. Cal,

I listened to your telephone conference December 8, on Boosting the Immune System through treatment interruptions. I didn't get an opportunity to ask any questions. In Boston there has been a study going on where patients treated during primary infection have been stopping and restarting HAART and are seeing some ability of the immune system to control the infection. I was wondering if there was a particular regimen that these patients were using? Is hydroxyurea an essential component? I started Combivir and Viracept during primary infection. I had a viral load of 6.7 million and a negative antibody test. I reached undetectable in less than 23 weeks and my CD4s are over 900. Also, is there a way to participate in clinical studies long distance using local labs and my own doctor?

Robert in Anchorage

Response from Dr. Cohen

Hey robert...

There isn't an easy way to participate in these studies at such a distance. But I can tell you that there is no clear difference in the success rates based on which antivirals are used. As long as the combo works - the virus is suppressed, and you feel well, then there is the chance it will work. By work, we mean that since you started during seroconversion, you might have preserved the cells that could control HIV, maybe some day without the meds. As you know, we discussed the next steps being tests - periodic stops and restarts of the meds in order to boost the immune response to HIV, since now, on this combo, your immune system doesn't "see" HIV anymore, and those cells, if they are there, aren't increasing in numbers. And the interruptions is one way to increase them.

But there is no commercial test your clinicians can order to measure those cells, nor see if they are increased off meds. Nor do we know the best way to do this, how well it works, when to stop, when to restart and so on. The study results are pretty interesting, but we are just learning the rules of this game. And while there may not be any studies where you are, we'll keep you posted...

Hope that helps. & Spring is coming, so hang in...



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