191–200 of 256 posts
I mean does the UN have existing programs that offer vaccines in the third world?
I mean it would be a shame to have a vaccine and not see it being used.
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I didn't quite follow joshstrange's accounting so I don't know if this is what he's describing, but (unless it's been changed recently), in some states it's legal for manufacturer of an expensive medication to give coupons to customers to reimburse them for their copay. This sounds like a nice, generous thing to do, but basically it means that the drug company is bribing the customer to force their insurance company…
Oh, wow... never even heard of that one. What a horror show.
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But it's not a simple, linear battle. That most virulent 1% then multiplies and infects systemwide... and adds new mutations all the time.
It's not the most virulent 1%, it's 1% which have unusual mutations that cause them to be resistant to this treatment, but which usually reduce their fitness in other respects. (This can be seen in humans as well, e.g. malaria resistance->sickle-cell). The fastest-multiplying viruses are also (obviously) going to be the most common, in the absence of treatment.
HIV evolves with amazing (super-villian-ic) speed. Many "cures" attack 99% of cells, or similar. Resistance is evolved during treatment, and is usually uniform within just a few months. It mutates/evolves so fast that given just virus samples, it is possible to determine sequence of infection. I think it needs to kill more than 6-9's before it has a good chance at being a cure.
A given strain can have some variability but will share general traits.
HIV strains are named and numbered: https://en.wikipedia.org/wiki/Subtypes_of_HIV
An efficient treatment against a specific strain would save millions of lives. An efficient treatment against the 99% of them that are the most prevalent would basically solve the epidemics.
The problem is that people often end up with more than one strain. This is why doctors tell HIV+ people to continue protect themselves and were worried about the appearance of "free-sex parties" for HIV+ individuals. Most people do not differentiate between strains but if you got HIV from a partner, you may have had only a part of their strains, you should not have unprotected sex if you want to maximize your chances.
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Not that it helps Africa but in the US for a drug like Truvada (PrEP) it costs ~$1500/mo on insurance but they offer a copay card that covers $3600/yr which is enough to hit my deductible at least so after 2 months I only pay $30/mo but in practice I don't pay a dime because the copay card covers it all.
Honestly, when you US folks talk about how your medical bills work and are paid there is so much jargon and complexity it sounds like Star Trek techno-babble to my ears. "I have a common but chronic ailment so all I had to do was re-route the phase-converter to the deflector shield and invert the chromaton particles in Shelk-Einstein space and we're done!" :/
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Not that it helps Africa but in the US for a drug like Truvada (PrEP) it costs ~$1500/mo on insurance but they offer a copay card that covers $3600/yr which is enough to hit my deductible at least so after 2 months I only pay $30/mo but in practice I don't pay a dime because the copay card covers it all.
Drugs are cheaper and largely subsidized by governments with high incidence of HIV. *I'm South African, antiretrovirals are free.
Hopefully it's cheap and/or Bill Gates starts throwing money into producing it if it passes clinical trials. I have a feeling that Africa is where AIDS does the most damage, and I doubt they can afford the $1000/mo. it will certainly cost in the States.
If this is produced by Pfizer or some other company he is invested in, sure. Otherwise he will fall back to talking bs all day long like he does with Malaria. For those downvoting: His foundation made sure the WHO subcontracts all studies to companies he has a stake in. He isn't a saint, he is a capitalist.
He's doing it to win a Nobel prize, not for money.
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But it's not a simple, linear battle. That most virulent 1% then multiplies and infects systemwide... and adds new mutations all the time.
It's not the most virulent 1%, it's 1% which have unusual mutations that cause them to be resistant to this treatment, but which usually reduce their fitness in other respects. (This can be seen in humans as well, e.g. malaria resistance->sickle-cell). The fastest-multiplying viruses are also (obviously) going to be the most common, in the absence of treatment.
This is true not just for bacteria but also for other living creatures; for example animals that have lots of children have very short average lifespans.
It makes me think that every living species must be at the absolute cutting edge of its capabilities genetically-speaking.
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If you're getting treatment, the amount of HIV in your blood is regularly measured as your "viral load". It's possible, with treatment, for people with HIV to have a viral load labelled undetectable. To date, from an article I read, there have been no recorded transmissions from people with an undetectable viral load. https://www.preventionaccess.org/faq
Two questions arise: How many people taking retrovirals have undetectable levels of HIV? Are those people using condoms?
> How many people taking retrovirals have undetectable levels of HIV?
According to my wife's doctor, most of them. And if that changes, they attempt to adjust treatment to return to that state.
BTW, undetectable appears to mean 20 copies of viral DNA per ml of blood.
> Are those people using condoms?
Well, we were, for many years. But we wanted children, and so after her doctor actually encouraged us we conceived them the old-fashioned way. I really, really enjoyed sex without a condom after so many years, I must say.
Now we have all the children we want, and we ought to go back to condoms, but I find myself wondering about the risk vs. reward. I suppose we'll go back to condoms, but I yearn to forgo them -- it's just less intimate. I wonder how other couples feel.
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The infecting other people is mostly theoretical. As far as I know there is no actual instance of transmission from a person with an undetectable viral load on antiretroviral drugs to an uninfected person.
Interesting. What about mother-to-baby transmission?
Until a few years ago, C-section was recommended, but the current wisdom is that vaginal birth poses no greater risk for the baby.
Same with breastfeeding. Until a few years doctors would call CPS if a HIV+ woman admitted to breastfeeding her child. Now, our doctors encouraged my HIV+ wife to breastfeed.
OTOH she was the second (or third?) HIV+ woman in our city who dared to.
Worked out for us. Both kids are HIV-, as am I.