SingaporeSteve Posted February 11, 2004 Report Share Posted February 11, 2004 josh_ingu said: Two points: 1. No one would/should wait till developing full blown AIDS before starting a antiviral regime. It would/should start immediately after HIV positive status is diagnosed. The chance of successful management is much higher. and 2. A significant number of people, even following the correctly prescribed regime of the latest therapy are "non-responders", who the drugs do not help. -j- Josh - Latest guidelines from Europe and now the US indicate that HIV treatment should start when your either in the state of immediate infection (i.e sero converting is the term I think) or waiting until your CD4 count is around 200-300 mark, with a viral load below about 75,000. NOBODY recomends immediatte treatment anymore for someone tested positive (and not sero converting) and a CD4 count of say 400-500 with a decently low viral load as their are no proven benefits as the advantages of taking the medicines early. Starting at these revised levels has been proven to offer the same benefit as started as soon as you are diagnosed. The hot debate at the moment seems to be reducing the amount of time people have to take these still toxic medicines in order to improve life expectancy and reduce the amount of times medicines are changed due to resistance building up in the body. Also. if you look at statistics produced by treatment experts, they indicate that the amount of fall out (ie ineffective treatment) is slanted by drug addicts who do not take their medicines correctly. The average man or lady has extremely low failure rates these days on the newest medicines which require 3/4 tablets a day as against 3 - 4 times that number of pills just a few years ago. Cheers Link to comment Share on other sites More sharing options...
Guest Posted February 11, 2004 Report Share Posted February 11, 2004 >>>Fly - GPO Vir, is not considered a leading edge medicine for HIV treatment - the drugs used are old and have considerable side effects <<< of course. but considering that thailand is a developing nation it is a huge step forward that such antiretroviral medicines are actually available more or less free of cost for everyone. as long as the pharmagiants do not reduce the cost of the more advanced treatments to a level which the third world can afford, madicaments such as GPO - Vir are a life saver for tens millions. and given the battles the pharmaindustry have waged against GPO - Vir it is a wonder that people here have any sort of treatment. i am very happy personally that GPO - Vir is available for free now, otherwise i would have to pay now about 2000 baht a month for it for my wife's favourite uncle. the more expensive and advanced treatments i could never afford. >>>Also in Thailand, GPO Vir is in danger of being given to anyone with HIV/AIDS regardless of their CD4 count and Viral Load. <<< again, it is a developing nation here. you have approximatly 1 mio. infected in thailand (maybe even more). MSF has been very active since years in training of healthstaff all over the country to properly administer GPO - Vir in collaboration with the government. lets see how it goes. it is better than doing nothing. Link to comment Share on other sites More sharing options...
Guest Posted February 11, 2004 Report Share Posted February 11, 2004 Great and very informed answer about GPO-VIR. Link to comment Share on other sites More sharing options...
Guest Posted February 11, 2004 Report Share Posted February 11, 2004 i am very happy personally that GPO - Vir is available for free now, otherwise i would have to pay now about 2000 baht a month for it for my wife's favourite uncle. the more expensive and advanced treatments i could never afford. Does the government provide any subsidization at all for the more advanced treatments? And do you have an idea what they cost? Link to comment Share on other sites More sharing options...
Guest Posted February 11, 2004 Report Share Posted February 11, 2004 Fly - GPO Vir, is not considered a leading edge medicine for HIV treatment - the drugs used are old and have considerable side effects - the most obvious one of which is facial wasting as well as Liver problems. Hi SS: What percentage of GPO Vir users suffer those side effects? Link to comment Share on other sites More sharing options...
Guest Posted February 11, 2004 Report Share Posted February 11, 2004 Lot of them mid term, all of them long term. Link to comment Share on other sites More sharing options...
Guest Posted February 11, 2004 Report Share Posted February 11, 2004 so, what we do then? don't give 'em any medication at all? Link to comment Share on other sites More sharing options...
Guest Posted February 11, 2004 Report Share Posted February 11, 2004 zenseless said: i am very happy personally that GPO - Vir is available for free now, otherwise i would have to pay now about 2000 baht a month for it for my wife's favourite uncle. the more expensive and advanced treatments i could never afford. Does the government provide any subsidization at all for the more advanced treatments? And do you have an idea what they cost? i am not so sure. whn i have asked that question about two years ago they have said the cost for more advanced medication started around 10 000 baht a month. illusionary for most infected in thailand to be able to afford that. impossible for the government to carry such costs under a national healthcare. as long as pharmagiants don't lower the cost of the pills according to what countries actually can afford, people gotta make do with what they can afford. Link to comment Share on other sites More sharing options...
SingaporeSteve Posted February 11, 2004 Report Share Posted February 11, 2004 I dont know the stats for Thailand with this medicine, only that one of the 3 drugs within it is from the DDI/DDL family produced by Bristol Myers Squib. These are the medicines (particularly DDL) that have been associatted with facial wasting in numerous studies and therefore DDL is very rarely prescribed in the west anymore unless other treatment options are not working due to resistance. I have learnt a lot about HIV just by reading a website at www.thebody.com and reading answers to questions posed by people with HIV. Cheers Link to comment Share on other sites More sharing options...
Guest Posted February 11, 2004 Report Share Posted February 11, 2004 Use other generics but not GPO-VIR as first line of treatment. I perfectly understand what you mean, the budget constrains, and more things than you can imagine. Great that GPO-VIR is under the 30 Baht health scheme, BUT it's not the solution, the side effects mid and long term are huge. Another point is about the doctors 'training' in order to avoid resistance, that training is done in 30 seconds. The problem is not the doctors' training but having the people taking the drugs on regular basis, one pill every 12 hours (deadband 3 hours), not alcohol comsumption. One of the biggest problems with GPO-VIR is the impossibility of do an accurate dose of the stavudine, with the current two versions only 30 or 40 mg doses are possibles, and what is more important, the accurate dose of nevirapine, GPO-VIR dose for this one is 200 mg. Nevirapine is in many cases the cause of a huge rash, that is not life-threatening, but will discorage the people who is taking GPO-VIR of continue taking it. Link to comment Share on other sites More sharing options...
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