1 00:00:01,359 --> 00:00:06,002 Greetings, good evening. This is my second youtube video. 2 00:00:06,002 --> 00:00:10,029 Tonight i'm wanting to talk a little bit about a study I recently read. 3 00:00:10,029 --> 00:00:12,389 As I mentioned in my 4 00:00:12,389 --> 00:00:14,027 other video and 5 00:00:14,027 --> 00:00:18,076 blogs I quit my AIDS drugs about six years ago, 6 00:00:18,076 --> 00:00:23,399 so i find reports like this of great interest. The study is called LOTTI 7 00:00:23,399 --> 00:00:25,089 and that's L-O-T-T-I, 8 00:00:25,089 --> 00:00:28,073 stands for LOng-Term Treatment Interruption. 9 00:00:28,073 --> 00:00:30,059 10 00:00:30,059 --> 00:00:34,629 The study recently reported that those of us who have had success with treatment interuptions, 11 00:00:34,629 --> 00:00:36,029 or "vacations" 12 00:00:36,029 --> 00:00:38,051 might not be all that unusual 13 00:00:38,051 --> 00:00:42,059 There are two groups in the study which was done in Italy. 14 00:00:42,059 --> 00:00:43,539 15 00:00:43,539 --> 00:00:45,007 They were all 16 00:00:45,007 --> 00:00:47,025 patients taking 17 00:00:47,025 --> 00:00:50,022 HAART, Highly Active Antiretroviral Therapy 18 00:00:50,022 --> 00:00:53,009 or the "AIDS cocktails" 19 00:00:53,009 --> 00:00:59,002 and one group took the drugs continuously—that was one arm—the second arm 20 00:00:59,002 --> 00:01:02,065 took vacations, or interrupted their therapy, 21 00:01:02,065 --> 00:01:04,009 based on CD4 counts. 22 00:01:04,009 --> 00:01:07,004 The counts used in this study 23 00:01:07,004 --> 00:01:09,005 were 700... 24 00:01:09,005 --> 00:01:11,909 at 700 CD4 count 25 00:01:11,909 --> 00:01:15,018 patients on the STI (structured treatment interruption) arm could 26 00:01:15,018 --> 00:01:19,016 quit their drugs until their CD4 count dropped to 27 00:01:19,016 --> 00:01:21,083 350 or lower, at which time they 28 00:01:21,083 --> 00:01:23,077 would restart 29 00:01:23,077 --> 00:01:25,094 their drug treatment. 30 00:01:25,094 --> 00:01:29,093 What was really cool about this study is that 31 00:01:29,093 --> 00:01:34,087 over a fourth of the 0:01:32.440,0:01:34.870 patients in the STI arm, 32 00:01:34,087 --> 00:01:35,094 when they 33 00:01:35,094 --> 00:01:40,027 quit their drugs, they never had to restart, 34 00:01:40,027 --> 00:01:45,036 which has been my strategy since I quit the drugs six years ago. 35 00:01:45,036 --> 00:01:51,041 Though i would use a little bit different numbers for the CD4 counts,perhaps. 36 00:01:51,041 --> 00:01:53,057 The study 37 00:01:53,057 --> 00:01:58,007 really offers hope to people who are either taking, or facing 38 00:01:58,007 --> 00:02:01,026 the choice of taking antiretroviral drugs 39 00:02:01,026 --> 00:02:05,749 because of their concern for long-term effects or perhaps they are experiencing illness 40 00:02:05,749 --> 00:02:07,031 because of the toxicities. 41 00:02:07,031 --> 00:02:10,389 There really are no good reasons 42 00:02:10,389 --> 00:02:13,037 for HAART patientsto stay on the drugs continuously 43 00:02:13,037 --> 00:02:17,809 and indefinitely and there are several advantages to stopping them. 44 00:02:17,809 --> 00:02:20,419 There is reduced toxicity 45 00:02:20,419 --> 00:02:25,061 There were more cardiologicalproblems due to the effects of drug toxicity 46 00:02:25,061 --> 00:02:27,039 in the continuous arm 47 00:02:27,039 --> 00:02:29,049 than there were in the STI arm. 48 00:02:29,049 --> 00:02:30,018 And these problems 49 00:02:30,018 --> 00:02:35,049 are well-known. The modern clinical practice is to simply prescribed 50 00:02:35,049 --> 00:02:36,489 even more 51 00:02:36,489 --> 00:02:36,989 drugs 52 00:02:36,989 --> 00:02:39,004 to deal with the effects. 53 00:02:39,004 --> 00:02:40,056 The other 54 00:02:40,056 --> 00:02:41,033 known affect of 55 00:02:41,033 --> 00:02:44,139 continuous 56 00:02:44,139 --> 00:02:46,579 HAART drug use includes disfiguring body effects 57 00:02:46,579 --> 00:02:48,399 like lipdystrophy, 58 00:02:48,399 --> 00:02:52,016 liver disease, bone problems, and aberrant blood levels 59 00:02:52,016 --> 00:02:55,689 with lipids, enzymes and hormones. 60 00:02:55,689 --> 00:02:59,449 The big boogie man most frequently used to try to discourage 61 00:02:59,449 --> 00:03:02,279 patients from interrupting their HAART treatment 62 00:03:02,279 --> 00:03:04,004 is drug resistance. 63 00:03:04,004 --> 00:03:06,879 The LOTTI study 64 00:03:06,879 --> 00:03:10,099 found that 65 00:03:10,099 --> 00:03:13,499 drug resistance was higher in the continuous group. 66 00:03:13,499 --> 00:03:15,093 than it was in the STI group. 67 00:03:15,093 --> 00:03:18,329 In other words, being 68 00:03:18,329 --> 00:03:21,859 off the drugs didn't cause resistence, but being on them did. 69 00:03:21,859 --> 00:03:25,079 There is only one patient in the STI arm who developed resistance 70 00:03:25,079 --> 00:03:31,869 and that was while they were taking the drug, supposedly after achieving viral suppression. 71 00:03:31,869 --> 00:03:35,023 So this really contradicts the 72 00:03:35,023 --> 00:03:38,019 common wisdom that's usually heard 73 00:03:38,019 --> 00:03:41,209 in the doctor's offices. 74 00:03:41,209 --> 00:03:44,079 CD4counts. 75 00:03:44,079 --> 00:03:49,819 While about the same number of patients in each arm reached one of the so-called primary endpoints, 76 00:03:49,819 --> 00:03:51,359 which in this study 77 00:03:51,359 --> 00:03:57,659 was defined as death or disease those in the contiuous arm had a mean CD4 count of 78 00:03:57,659 --> 00:04:00,519 891, almost 900, 79 00:04:00,519 --> 00:04:04,669 compared to 557 in the STI arm.o 80 00:04:04,669 --> 00:04:05,949 81 00:04:05,949 --> 00:04:07,299 So, having higher 82 00:04:07,299 --> 00:04:09,859 level of CD4 counts, in this study at any rate, 83 00:04:09,859 --> 00:04:12,239 did not result in lowering 84 00:04:12,239 --> 00:04:15,659 either death or disease. So much for the 85 00:04:15,659 --> 00:04:18,053 protective power of high CD4 counts. 86 00:04:18,053 --> 00:04:20,059 The daily drug costs... 87 00:04:20,059 --> 00:04:23,219 treatment cost for patients on the STI arm 88 00:04:23,219 --> 00:04:25,529 was less than half that of the continuous drug group. 89 00:04:25,529 --> 00:04:28,169 90 00:04:28,169 --> 00:04:30,819 Now, cost alone should never be 91 00:04:30,819 --> 00:04:35,559 the determining factor in treatment choices, 92 00:04:35,559 --> 00:04:37,093 but there never seems to be enough money 93 00:04:37,093 --> 00:04:41,659 to fuel the AIDS machine, so 94 00:04:41,659 --> 00:04:46,189 this is an important finding too. 95 00:04:46,189 --> 00:04:48,639 The other study that's or 96 00:04:48,639 --> 00:04:51,749 pretty widely quoted when 97 00:04:51,749 --> 00:04:55,009 drug vacations or structured treatment interruptions are 98 00:04:55,009 --> 00:04:56,409 mentioned, 99 00:04:56,409 --> 00:04:59,319 is the SMART study, which was funded 100 00:04:59,319 --> 00:05:03,056 by the U.S. National Institute of Allergy and Infectious Diseases (NIAID). 101 00:05:03,056 --> 00:05:08,829 This was an international study with over 5400 patients 102 00:05:08,829 --> 00:05:14,789 in 33 countries. The study was terminated early 103 00:05:14,789 --> 00:05:19,052 because supposedly of too many deaths and adverse affects. What's really strange 104 00:05:19,052 --> 00:05:22,889 about this study is that 105 00:05:22,889 --> 00:05:29,049 79 of those 85 deaths 106 00:05:29,049 --> 00:05:31,071 occurred in the U.S. 107 00:05:31,071 --> 00:05:34,369 even those only 55% of the patients in the study were from the U.S. 108 00:05:34,369 --> 00:05:37,055 These and other weird aberrations about this study are mentioned in a link 109 00:05:37,055 --> 00:05:44,097 that is in my report on the LOTTI study on my blog, 110 00:05:44,097 --> 00:05:46,269 which I hope 111 00:05:46,269 --> 00:05:51,057 you'll go and actually look at the study itself, and I write a little bit more 112 00:05:51,057 --> 00:05:53,079 about LOTTI 113 00:05:53,079 --> 00:05:54,091 114 00:05:54,091 --> 00:05:59,569 and raise questions about why isn't this 115 00:05:59,569 --> 00:06:01,002 information being 116 00:06:01,002 --> 00:06:02,789 more widely publicized. 117 00:06:02,789 --> 00:06:05,093 You won't find 118 00:06:05,093 --> 00:06:08,339 any promotion of of the 119 00:06:08,339 --> 00:06:11,729 information from LOTTIon the pharmaceutical funded 120 00:06:11,729 --> 00:06:13,091 AIDS sites like AIDS.com... 121 00:06:13,091 --> 00:06:17,003 AIDSmeds.com, poz.com. 122 00:06:17,003 --> 00:06:18,068 thebody.com... 123 00:06:18,068 --> 00:06:21,539 which is which is just 124 00:06:21,539 --> 00:06:23,259 inexcusable to me. 125 00:06:23,259 --> 00:06:25,169 126 00:06:25,169 --> 00:06:27,005 I know of friends and other people who are on HAART, 127 00:06:27,005 --> 00:06:30,019 and i support their choices in the decision to take 128 00:06:30,019 --> 00:06:31,399 those drugs. 129 00:06:31,399 --> 00:06:33,379 130 00:06:33,379 --> 00:06:35,018 My point is that 131 00:06:35,018 --> 00:06:36,699 decisions... 132 00:06:36,699 --> 00:06:40,029 we need information 133 00:06:40,029 --> 00:06:41,639 to make informed decisions. 134 00:06:41,639 --> 00:06:44,509 This is important information that every person 135 00:06:44,509 --> 00:06:46,028 who is facing 136 00:06:46,028 --> 00:06:50,799 this choice should have. 137 00:06:50,799 --> 00:06:52,093 I know people who are 138 00:06:52,093 --> 00:06:55,046 having problems with the drugs but are 139 00:06:55,046 --> 00:06:58,569 scared to death, basically, to quit 140 00:06:58,569 --> 00:06:59,003 and 141 00:06:59,003 --> 00:07:02,027 we need more 142 00:07:02,027 --> 00:07:04,639 of this type of encouragement 143 00:07:04,639 --> 00:07:07,052 that there's really not... 144 00:07:07,052 --> 00:07:09,469 there's not as much to lose 145 00:07:09,469 --> 00:07:13,149 to give it a try now and it doesn't work, you can go back on the drugs. 146 00:07:13,149 --> 00:07:15,009 If it does, 147 00:07:15,009 --> 00:07:16,999 you might never have to 148 00:07:16,999 --> 00:07:18,949 go back on them. 149 00:07:18,949 --> 00:07:22,369 That's my hope, at any rate 150 00:07:22,369 --> 00:07:25,027 Go check out the blog. Its 151 00:07:25,027 --> 00:07:28,056 resistanceisfruitful.com (new URL) 152 00:07:28,056 --> 00:07:32,499 There's a link to in on the youtube page here. 153 00:07:32,499 --> 00:07:36,199 Read the study, read my report, feel free to comment. 154 00:07:36,199 --> 99:59:59,999 Thanks.