Medical Forum / Diseases and Disorders / AIDS / April 2007
HAART reduces HIV/AIDS mortality by 80%
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Gary Stein - 29 Mar 2007 18:21 GMT HIV related and non-HIV related mortality before and after the introduction of highly active antiretroviral therapy (HAART) in Norway compared to the general population.
Ormaasen V, Sandvik L, Dudman SG, Bruun JN.
Department of Infectious Diseases, Ulleval University Hospital, Oslo, Norway. vidar.ormaasen@medisin.uio.no
The objective of the study was to compare the mortality in HIV infected individuals to the general population, and to explore the relative contribution of HIV to mortality before and after the introduction of highly active antiretroviral therapy (HAART). All HIV patients attending Ulleval University Hospital, Oslo, Norway before (cohort 1) and after (cohort 2) the introduction of HAART were included. Causes of deaths were classified as HIV related or not. Mortality in the Norwegian general population was standardized according to the distribution of age and gender in our cohorts.
Ratios between mortality in our cohorts and the standardized mortality were calculated. The risk ratio (RR) for 5-y mortality compared to the general population was 22.6 (95% confidence interval (CI), 19.5-26.4) in cohort 1 (n = 782), and 3.96 (95% CI 2.25-6.97) in cohort 2 (n = 398). The non-HIV related mortality RR was 4.42 (95% CI 3.18-6.13) in cohort1 and 0.89 (95% CI 0.29-2.76) in cohort 2. Higher age and low CD4 cell count were associated with increased mortality.
Thus, in the HAART era the mortality in HIV patients was reduced by 80%. However, the mortality in the HAART era was still 4 times higher than in the general population.
PMID: 17366013 [PubMed - in process]
 Signature Gary Stein ge.stein@verizon.net
Death - 29 Mar 2007 23:36 GMT "Gary Stein" <ge.stein@verizon.net> wrote in message
> HIV related and non-HIV related mortality before and after the introduction > of highly active antiretroviral therapy (HAART) in Norway compared to the > general population. That statement (above) is meaningless. Have you really read it?
DavidT - 30 Mar 2007 10:14 GMT > "Gary Stein" <ge.st...@verizon.net> wrote in message > > HIV related and non-HIV related mortality before and after the introduction [quoted text clipped - 3 lines] > That statement (above) is meaningless. > Have you really read it? Have you? They studied their historical cohorts pre and post HAART. Those who are on HAART have a much lower mortality than those who didn't. However, their mortality was still higher than that of the standardised Norwegian population data.
Death - 30 Mar 2007 16:59 GMT "DavidT" <avid199@volcanomail.com> wrote in message
> > "Gary Stein" <ge.st...@verizon.net> wrote in message
> > > HIV related and non-HIV related mortality before and after the introduction > > > of highly active antiretroviral therapy (HAART) in Norway compared to the [quoted text clipped - 4 lines] > > Have you? Obviously.
> They studied their historical cohorts pre and post HAART. >Those who are on HAART have a much lower mortality than those who didn't. That would be the HIV positive vs the HIV positive. Those taking the treatment and those not taking treatment.
The comparison between the HIV infected and the non-HIV related and the general population is a game with the numbers.
DavidT - 30 Mar 2007 18:56 GMT > The comparison between the HIV infected and the non-HIV related > and the general population is a game with the numbers. Quite. Why do you find it meaningless? It is quite helpful to know that HIV patients on HAART have a higher mortality than the general population, but that they still fare much better than those who were never given HAART.
Death - 30 Mar 2007 19:29 GMT "DavidT" <david199@volcanomail.com> wrote in message
> Quite. > Why do you find it meaningless? > ... Once it can be demonstrated that there is a false premises every-thing that follows has to be incorrect.
Creditability is thrown away for an agenda.
monty1945@lycos.com - 31 Mar 2007 05:03 GMT And a successful suicide reduces your risk of getting heart disease to zero.
"HIV Positive" - 31 Mar 2007 21:18 GMT >HIV related and non-HIV related mortality before and after the introduction >of highly active antiretroviral therapy (HAART) in Norway compared to the >general population. It would be interesting to know how the term 'HIV related mortality' is defined.
>Mortality in the Norwegian general population was >standardized according to the distribution of age and gender in our cohorts. Fair enough. However I doubt the type of person likely to be tested for HIV and/or given an HIV+ result is comparable to the Norwegian general population.
 Signature URL: http://hiv.positive.googlepages.com/ Moible: +447939991519
Gary Stein - 03 Apr 2007 20:46 GMT >>HIV related and non-HIV related mortality before and after the >>introduction [quoted text clipped - 11 lines] > for HIV and/or given an HIV+ result is comparable to the Norwegian > general population. What difference would that make to the results of this study, none as far as I can see. If, as you are supposing, those who get tested for HIV or have HIV are less healthy then the normal population then that would be reflected in there mortality rate just as this study shows they are.
That has nothing to do with the effects of HAART for that you look at the differences in mortality in the Pre-HAART versus the Post-HAART cohorts.
Gary Stein
rocketscience12@gmail.com - 04 Apr 2007 14:22 GMT > >>HIV related and non-HIV related mortality before and after the > >>introduction [quoted text clipped - 23 lines] > > - Show quoted text - HAART is not recommended because it causes more harm than good from severe side effects (cardiac, liver toxicity, lipodystrophuy etc.). A toxic drug can not remove pro-viral DNA from the genome, so the entire toxic drug approach is useless.
Dr. Ibanez says: "our findings suggest that 48 weeks of HAART does not significantly reduce the integrated HIV-1 proviral DNA load in the latently infected CD4 T cell reservoir".
Ibanez A et al. Quantification of integrated and total HIV-1 DNA after long-term highly active antiretroviral therapy in HIV-1-infected patients. AIDS. 1999 Jun 18;13(9):1045-9.
For Discussion of HAART risks and lack of benefit: http://www.virusmyth.net/aids/data/dchaart.htm
references:
The Lancet February 24, 2001 (Volume 357, Number 9256) Risk of Lipodystrophy in HIV-1 Infected Patients Treated With Protease Inhibitors: A Prospective Cohort Study Martinez E, Mocroft A, Garcia- Viejo MA, et al.The Lancet. 2001;357(9256):592-598
"Body shape changes are emerging as a major and distressing complication of HIV in the era of HAART. The prevalence and causes of changes such as fat accumulation and fat wasting are not clear."
Lewden C, Salmon D, Morlat P et al.
Causes of death among HIVinfected adults in the era of potent antiretroviral therapy: emerging role of hepatitis and cancers, persistent role of AIDS. Int J Epidemiol doi:10.1093/ije/dyh307.
Carr A, Samaras K, Thorisdottir A, Kaufmann GR, Cisholm Cooper DA.
Diagnosis, prediction, and natural course of protease-inhibitor- associated lipodystrophy, hyperlipidaemia, diabetes mellitus: a cohort study. Lancet 1999;354:2093-99.
The Data Collection on Adverse Events of Anti-HIV Drugs Study Group. Combination Antiretroviral Therapy and the Myocardial Infarction. N Engl J Med 2003;349:1993-2003.
RocketScience
GMCarter - 05 Apr 2007 11:47 GMT snip
>HAART is not recommended by whom?
>because it causes more harm than good says you.
>from >severe side effects (cardiac, liver toxicity, lipodystrophuy etc.). A [quoted text clipped - 4 lines] >significantly reduce the integrated HIV-1 proviral DNA load in the >latently infected CD4 T cell reservoir". That doesn't mean that the viral load reductions don't have a clinically significant benefit.
It means antiretrovirals are not a cure. They are a treatment.
Ibanez I am CERTAIN does not suggest people NOT use ARV.
AIDS is significantly worse than most all of the side effects of ARV.
Wow. The denialists are getting desperate to make a point of any kind.
George M. Carter
rocketscience12@gmail.com - 06 Apr 2007 13:23 GMT Regarding the lack of value in reducing surrogate HIV RNA viral load markers with toxic drugs:
This Lancet article shows that HAART treatment of HIV can produce improvement in surrogate markers such as reduction in viral load (HIV RNA PCR), however, "but such improvement has not translated into a decrease in mortality" (author's quote) (1)
Not only that, but this JAMA article shows that HIV viral load markers cannot even predict which individual HIV positives will have CD4 cell count decline (which is the current definition of AIDS). (2)
Of course, this is old news, since others such as Hogg, have shown that HIV RNA Viral Load Surrogate markers, were not significant. " Only CD4 cell count remained statistically significant in the multivariate analysis of progression to death". (author's quote) (3)
The reason for this is that unlike the human influenza A virus (4), death from AIDS is NOT associated with high plasma viremia. In fact it is extremely difficult to demonstrate HIV virus in the blood of AIDS patients. That's why reliance is placed on the RNA PCR test which amplifies tiny amounts RNA. And why after 20 years of research and 100 B NIH dollars, there are still serious questions about the entire HIV causes AIDS hypothesis. However, the money pot is so large and tempting; the HIV causes AIDS blunder must continue. How many messages on the internet are posted by paid shills for the drug industry or by member of the research community who are funded by the NIH ? That funding dries up once the blunder is admitted.
David Pratt sums it up quite well:
"A person's 'viral load' is determined by means of the polymerase chain reaction (PCR) test. But this test does not detect actual virus. It amplifies millions of times small genetic segments assumed to be associated with 'HIV' so that they become detectable, and these fragments of genetic material are then assumed to correspond to counts of actual virus. Using this method, an average of over 100,000 HIVs per millilitre of blood are found in AIDS patients. However, when standard virus-counting methods, are applied, a viral load of 100,000 is found to correspond to less than 10 infectious units of HIV - far too little to induce illness.
Viral loads have been measured in people who are HIV-negative and in AIDS patients who test HIV-antibody positive but have no HIV. Low viral loads do not correlate with high T-cell counts or good health, while high viral loads do not correspond with low T-cell counts or sickness. Kary Mullis, who won the Nobel Prize in 1993 for inventing PCR, says that the conclusions being drawn from PCR's use in these tests are worthless. Some critics have bluntly characterized this new hypothesis as 'a viral load of crap'."
references:
(1) http://tinyurl.com/2tcpgx
"INTERPRETATION: Virological response after starting HAART improved over calendar years, but such improvement has not translated into a decrease in mortality."
HIV treatment response and prognosis in Europe and North America in the first decade of highly active antiretroviral therapy: a collaborative analysis. Lancet
(2) http://jama.ama-assn.org/cgi/content/abstract/296/12/1498
Predictive Value of Plasma HIV RNA Level on Rate of CD4 T-Cell Decline in Untreated HIV Infection Benigno Rodríguez,
(3) http://jama.ama-assn.org/cgi/content/abstract/286/20/2568
Rates of Disease Progression by Baseline CD4 Cell Count and Viral Load After Initiating Triple-Drug Therapy
Robert S. Hogg, PhD; Benita Yip, BSc(Pharm); Keith J. Chan, MSc; Evan Wood, BSc; Kevin J. P. Craib, MMath; Michael V. O'Shaughnessy, OBC,PhD; Julio S. G. Montaner, MD,FRCPC,FCCP
JAMA. 2001;286:2568-2577.
Context Current recommendations for initiation of antiretroviral therapy in patients infected with human immunodeficiency virus type 1 (HIV) are based on CD4 T-lymphocyte cell counts and plasma HIV RNA levels. The relative prognostic value of each marker following initiation of therapy has not been fully characterized.
Objective To describe rates of disease progression to death and AIDS or death among patients starting triple-drug antiretroviral therapy, stratified by baseline CD4 cell count and HIV RNA levels.
Design, Setting, and Participants Population-based analysis of 1219 antiretroviral therapy-naive HIV-positive men and women aged 18 years or older in British Columbia who initiated triple-drug therapy between August 1, 1996, and September 30, 1999.
Main Outcome Measure Cumulative mortality rates from the initiation of triple-drug antiretroviral therapy to September 30, 2000, determined using various CD4 cell and plasma HIV RNA thresholds.
Results As of September 30, 2000, 82 patients had died of AIDS- related causes, for a crude AIDS-related mortality rate of 6.7%. The product limit estimate (SE) of the cumulative mortality rate at 12 months was 2.9% (0.5%). In univariate analyses, a prior diagnosis of acquired immunodeficiency syndrome (AIDS), CD4 cell count, use of protease inhibitors, and HIV RNA level were associated with mortality. There was no difference in mortality by age or sex. Only CD4 cell count remained statistically significant in the multivariate analysis. After controlling for AIDS, protease inhibitor use, and plasma HIV RNA level at baseline, patients with CD4 cell counts of less than 50/µL were 6.67 (95% confidence interval [CI], 3.61-12.34) times and those with counts of 50/µL to 199/µL were 3.41 (95% CI, 1.93-6.03) times more likely to die than those with counts of at least 200/µL.
Conclusion Our data demonstrate uniformly low rates of disease progression to death and AIDS or death among patients starting antiretroviral therapy with CD4 cell counts of at least 200/µL. In our study, disease progression to death and AIDS or death was clustered among patients starting therapy with CD4 cell counts less than 200/ µL.
(4) http://www.nature.com/nm/journal/v12/n10/abs/nm1477.html
Nature Medicine - 12, 1203 - 1207 (2006)
Fatal outcome of human influenza A (H5N1) is associated with high viral load and hypercytokinemia
Menno D de Jong1, Cameron P Simmons
Avian influenza A (H5N1) viruses cause severe disease in humans1, 2, but the basis for their virulence remains unclear. In vitro and animal studies indicate that high and disseminated viral replication is important for disease pathogenesis3, 4, 5. Laboratory experiments suggest that virus-induced cytokine dysregulation may contribute to disease severity6, 7, 8, 9. To assess the relevance of these findings for human disease, we performed virological and immunological studies in 18 individuals with H5N1 and 8 individuals infected with human influenza virus subtypes. Influenza H5N1 infection in humans is characterized by high pharyngeal virus loads and frequent detection of viral RNA in rectum and blood. Viral RNA in blood was present only in fatal H5N1 cases and was associated with higher pharyngeal viral loads. We observed low peripheral blood T-lymphocyte counts and high chemokine and cytokine levels in H5N1-infected individuals, particularly in those who died, and these correlated with pharyngeal viral loads. Genetic characterization of H5N1 viruses revealed mutations in the viral polymerase complex associated with mammalian adaptation and virulence. Our observations indicate that high viral load, and the resulting intense inflammatory responses, are central to influenza H5N1 pathogenesis. The focus of clinical management should be on preventing this intense cytokine response, by early diagnosis and effective antiviral treatment.
(5) http://ourworld.compuserve.com/homepages/dp5/aids.htm
Death - 06 Apr 2007 22:15 GMT <rocketscience12@gmail.com> wrote in message
Kary Mullis, who won the Nobel Prize in 1993 for inventing PCR, says that the conclusions being drawn from PCR's use in these tests are worthless. Some critics have bluntly characterized this new hypothesis as 'a viral load of crap'."
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Lol. There needs to be a test to check for HIV in crap. I suggest more hiv would be found there than in the blood.
rocketscience12@gmail.com - 06 Apr 2007 23:20 GMT > <rocketscienc...@gmail.com> wrote in message > [quoted text clipped - 7 lines] > Lol. There needs to be a test to check for HIV in crap. > I suggest more hiv would be found there than in the blood. It has already been done by Beatrice Hahn who checked for HIV in crap - chimp crap.
http://tinyurl.com/yrdmg5
30% of chimp crap is positive for HIV by western blot and PCR, yet chimps dont get AIDS.
And Chimps don't tranmit AIDS to humans.
RocketScience
Death - 07 Apr 2007 01:17 GMT <rocketscience12@gmail.com> wrote in message
> And Chimps don't tranmit AIDS to humans. I remember the rush for funding when that was the in-thing. Looking for the missing link, lol
Some-one will infect a dolphin with hiv and get funding to prove Chicken of the Sea infected people with their tuna-fish.
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