April #100 : Head Games - by Tim Murphy

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Getting Out Alive

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He Said, He Said

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Myth vs. Reality in the Pen

The Hook-Up

Africa’s Mayor

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Can HIV Care Click in the Clink?

A Bitter Pill

Comfort Zone: SpiceBoy

The Sweetest Taboo

Diamond in the Roughage

Head Games

Looking for Liver Helpers

Quick Study: Painkiller

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What is AIDS & HIV?

Hepatitis & HIV


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April 2004

Head Games

by Tim Murphy

In which our fearless HIVer probes a study of viral brain drain

As an HIVer, I quake at studies implying that HAART doesn’t help enough. Take recent research that timed responses of 31 HIVers vs. 35 neggies to stimuli. Though the naked eye observed no difference, a high-tech brain-wave test showed that “potential was greatly reduced” among the HIVers—even those on meds with undetectable virus, says lead author Linda Chao, MD.

Hmmm. I knew for starters that “AIDS dementia,” which once affected one in five PWAs, has virtually disappeared among HIVers on effective HAART, despite the fact that HIV can get through our blood-brain barrier (BBB)—a bag-like filter separating our bloodstream from our brain, spine and cerebrospinal fluid. So virus that’s undetectable in the blood may be a bit higher in those areas. Still, some HIV meds cross the BBB to fight HIV inside the bag. The University of California San Diego’s Ron Ellis, MD, says Retrovir (AZT), Zerit (d4T), Ziagen (abacavir), Viramune (nevirapine) and Crixivan (indinavir) seem to pierce the BBB best but that some other potent meds may do it too. Yet Chao says it didn’t really matter what meds her HIVers were on—they still tested lousy compared to the neggies.

So should I worry about losing my mind? Not really, says my personal brain trust.

David Gelman, MD, POZ science editor, says he worries about brain damage in HIVers on HAART as much as he does about lymphoma, which hits only 4 percent of HIVers (and is easier to treat in the HAART era).

My first HIV doc, Cal Cohen, MD, downplays “such a small study of something so subtle—it doesn’t fit with my understanding of what’s happening in general.”

And longtime HIVer bud Tim Horn, of www.aidsmeds.com, says we can try (if possible) to be on one of the BBB-crossing meds, but that goal “isn’t worth losing sleep over.”

So, Dr. Chao, what sayest thou now? While conceding that her study was too small to be conclusive, she says it still suggests “the importance of developing regimens that do a better job crossing the BBB. As good as HAART is, it could be better.” Now that, I agree, is a no-brainer.




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