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A Blue Pill Is Stopping HIV, World-First Study Shows

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Re: A Blue Pill Is Stopping HIV, World-First Study Shows

#71

Post by dillondoyle »

JumpCrisscross wrote: post #26
dawhizkid wrote: post #24

And yet STD rates are skyrocketing in the US. I take Truvada but it’s used as an excuse in the gay commmunity to engage in unprotected sex. If anything the availability of Truvada is probably a leading cause of why STD rates in the gay community are increasing.

> STD rates are skyrocketing in the US Source? (If frequencies of curable STDs are rising while those of incurable ones are falling, that would be a good trade.)

I have strong personal anecdotal evidence that casual hookups are much more upfront about condom-less sex and in fact I find that a shockingly high percent outright refuse condom sex (e.g. bareback only).

I'm not sure if the actual condom use rate is lower (I wouldn't be surprised) but in my experience the upfront non-condom attitudes is staggering and way higher than 10 years ago. Tech, attitudes, PrEP have shifted culture and depressingly for me lowers match rates from an already tiny population in my experience by more than 50% of guys on hook up apps !

Re: A Blue Pill Is Stopping HIV, World-First Study Shows

#72

Post by jsperx »

chimeracoder wrote: post #20
drewmassey wrote: post #11

Earlier quoted context omitted.

Yeah this is true. The cost of generics is so low but in the United States it remains quite expensive if you don’t have insurance.

> but in the United States it remains quite expensive if you don’t have insurance. Not really - Gilead provides assistance programs for people who have private insurance, for people on public insurance, and for people who are uninsured (there are three separate assistance programs). The plan for people who have private insurance is the best (you end up paying $0/year for PrEP), and the plan for people who are uninsur…

I have personally paid $1700 out of pocket for a month’s supply of PrEP, despite insurance AND membership in Gilead’s “advancing access” co-pay assistance program.

Gilead intended the program to cover about $300/mo, in order to cover your co-pay until your deductible is satisfied. That worked fine until this year, when UnitedHealthcare decided to re-class my card from co-pay assistance to a “manufacturer’s coupon” — thus accepting Gilead’s money while it lasted but still expecting me to pickup the full tab until my deductible.

:(

Re: A Blue Pill Is Stopping HIV, World-First Study Shows

#73

Post by jsperx »

matthewmacleod wrote: post #8

The effectiveness of the tenofovir and emtricitabine combination is hard to overstate. Other studies show almost 100% prevention of infection; to my knowledge there have only been two recorded infections in people who were reliably taking PReP, both of which were due to unusual, rare mutations. This sort of thing is a step change for vulnerable populations; hopefully it ends up being widely accessible. The combinatio…

There have now been six: https://www.out.com/news-opinion/2018/10/09/sixth-case-man-c...

Re: A Blue Pill Is Stopping HIV, World-First Study Shows

#74

Post by peterlk »

vecter wrote: post #68
matthewmacleod wrote: post #8

The effectiveness of the tenofovir and emtricitabine combination is hard to overstate. Other studies show almost 100% prevention of infection; to my knowledge there have only been two recorded infections in people who were reliably taking PReP, both of which were due to unusual, rare mutations. This sort of thing is a step change for vulnerable populations; hopefully it ends up being widely accessible. The combinatio…

What is the possibility of more widespread drug resistance as the HIV strains that exhibit immunity are selected for?

Can someone provide a compelling argument for why we should not keep charging ahead given this risk? It seems to me that drug-resistant HIV would maintain the status quo, but I don't really know anything about the landscape of drugs/resistance in HIV

Re: A Blue Pill Is Stopping HIV, World-First Study Shows

#75

Post by masonic »

uniblih wrote: post #66
hndamien wrote: post #60

Earlier quoted context omitted.

If you have a link for the genital herpes cure you will be rich.

> If you have a link for the genital herpes cure you will be rich. May never happen [0], but one can wish. Although it doesn't have a cure, the treatability, prevalence, and general harmlessness of herpes make it less of an issue than the "curable" STDs. Most doctors don't even bother testing for it [1]. [0] https://www.healthline.com/health-news/why-we-still-dont-hav... [1] https://www.cdc.gov/std/herpes/screening.h…

  general harmlessness of herpes
Perhaps you missed that HSV is a vector for cancers (e.g Kaposi sarcoma).

Re: A Blue Pill Is Stopping HIV, World-First Study Shows

#76

Post by killjoywashere »

sigmar wrote: post #59
killjoywashere wrote: post #58

Earlier quoted context omitted.

Thinking of remote possibilities and assuming your patients could be lying to you (corollary: trust but verify) is pretty standard practice in medicine.

and your solution to these adversarial patients that are willing to lie is to... ask a second question?

Whether Bayesian or Frequentist, surely you can agree the result of different tests are unlikely to have 100% concordance.

Re: A Blue Pill Is Stopping HIV, World-First Study Shows

#77

Post by canekong »

killjoywashere wrote: post #22

Interesting problem we're dealing with: Truvada potentially makes it harder to identify HIV+ blood donors (as their antibody titers fall naturally over time) and raises the question of whether HIV+ individuals will be more likely to attempt to donate in order to "prove they're safe". It is a well-known fact in their community that men having sex with men are deferred from being blood donors for 12 months from last ma…

As a gay man on prep, I find this comment quite offensive.

Within my circle of friends (some of whom are quite adventurous) none of them says “let’s donate blood and see what happens”.

Furthermore being on PrEP requires strict complete STD testing (Chlamydia, Syphillis, HIV, included) testing every 3 months before allowed to be prescribed again. The same time interval as any recommended STD testing.

I had a discussion with my Dr last week about Truvada on similar topic. Her reply was that Truvada is not enough to suppress viral load and thus they can be detected if a person is infected still and is not on treatment. Also Truvada is not magic pill and can take time to take effect (about 1-2 weeks) and there have been cases of people getting infected while on PrEP because their drugs haven’t taken effect yet.

Re: A Blue Pill Is Stopping HIV, World-First Study Shows

#78

Post by dogma1138 »

esf wrote: post #49
dogma1138 wrote: post #47

Earlier quoted context omitted.

I don’t know why is this being downvoted. Anti bodies are produced to combat a pathogen if the levels of the pathogen are below of what would trigger the immune system you will not produce anti bodies and the ones that you have had produced will fade of over time you don’t have anti bodies for every pathogen you encounter flowing through your blood that would likely kill you. If the pill can reduce the virus to trace…

The pill was already part of HIV trratment, it does nothing to change the effectiveness of HIV tests. The only unknown would be whether if you are one of the very, very few people that manages to contract HIV while taking prep, your antibody response is different during that initial window. But: Anyone in that situation is already covered by the questions about recent partners and already is not donating if answering…

>The pill was already part of HIV trratment, it does nothing to change the effectiveness of HIV tests.

Where is that stated?

>But: Anyone in that situation is already covered by the questions about recent partners and already is not donating if answering the existing questions in good faith. If they are donating in this situation at all they are already just ignoring the questions.

I think you missed the entire point of the GP this isn’t about someone acting in good faith or rationally.

Re: A Blue Pill Is Stopping HIV, World-First Study Shows

#79

Post by AllegedAlec »

peterlk wrote: post #74
vecter wrote: post #68

Earlier quoted context omitted.

What is the possibility of more widespread drug resistance as the HIV strains that exhibit immunity are selected for?

Can someone provide a compelling argument for why we should not keep charging ahead given this risk? It seems to me that drug-resistant HIV would maintain the status quo, but I don't really know anything about the landscape of drugs/resistance in HIV

> I don't really know anything about the landscape of drugs/resistance in HIV

HIV is a retrovirus with an absurdly high mutation rate (4 × 10−3 per base per cell, Cuevas, J. et al, 2015). In comparison: the mutation rate of influenza is about one or two orders of magnitude lower. This means that it is incredibly quick to adapt to any changes.

Re: A Blue Pill Is Stopping HIV, World-First Study Shows

#80

Post by esf »

masonic wrote: post #75
uniblih wrote: post #66

Earlier quoted context omitted.

> If you have a link for the genital herpes cure you will be rich. May never happen [0], but one can wish. Although it doesn't have a cure, the treatability, prevalence, and general harmlessness of herpes make it less of an issue than the "curable" STDs. Most doctors don't even bother testing for it [1]. [0] https://www.healthline.com/health-news/why-we-still-dont-hav... [1] https://www.cdc.gov/std/herpes/screening.h…

general harmlessness of herpes Perhaps you missed that HSV is a vector for cancers (e.g Kaposi sarcoma).

Kaposi Sarcoma is caused by HHV-8, a completely different virus than HSV-1/2. They are in the herpes virus family, but this is a huge virus group including eg chicken pox (HHV-3) and Epstein Barr virus that causes mono (HHV-4).
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