Michael Wolff, about as good an indicator of the snide new York left as you’ll find outside the New York Times op-ed page, vents revealingly about the ascendancy of George W. Bush. Like much that Wolff writes, this is pure onanism. It has no relationship to actual reporting, research or honest examination of something called policy. It’s just how he feels. Well, he feels bad. He wants a return to the days when Bush was ridiculed. He fears, in the way that a substratum of provincial Manhattanites often fears, that any popular Republican is a harbinger of the Fourth Reich (he even uses the Nazi analogy.) Anyway, this is all to say that his column cheered me up no end. If this is how Wolff feels right now, a lot of things must be right in the world.
MOVE OVER, SEGWAY: Here’s an invention that really changes our lives.
AIDS NOW: An interesting piece in the Washington Post today about research into the possibility of ‘cycling’ anti-HIV drugs. It seems that in many cases, taking constant ‘holidays’ from the relentless drug regimen doesn’t adversely affect your immune system, can halve the cost of treatment, and reduces side effects. This is big news – both for healthcare costs and also for HIV patients. For what it’s worth, my own experience bears it out. Last June, on the eighth anniversary of my becoming HIV-positive, my blood results came back. They showed an undetectable viral load – i.e. there were fewer than 50 viral particles in a milligram of my blood. And my T-cell count (CD4 cells), an indicator of the strength of the immune system, was a solid 495. (People’s immune systems vary – but the range of normal CD4 counts is between 500 and 1500, with most people in the middle. You only risk illness if the count goes below 200. Viral loads also vary. They can go as high as several million in people with AIDS and vary from a few hundred to hundreds of thousands in other people with HIV). I decided, with my doctors’ blessing, to take a break from my meds. The fatigue, diarrhea, and nausea were getting to me. I found myself forgetting doses. I had begun to develop weird fat deposits around my waist and between my shoulder blades. So I tried an experiment.
THE RESULTS: Since the experiment started, I’ve had three blood tests. Off my medications, my immune system actually strengthened a little, going from 495 CD4 cells to three measurements over 600. My viral load came back, however. From being undetectable, it went to 2500 in two months, then leaped to 48,000 in the wake of 9/11, but now it has declined back again to 6800. No one knows quite what’s going on, but it appears my own immune system is fighting HIV quite effectively on its own. With a low viral load and high CD4 cells, my docs recommend staying off my meds for the time being. I’ll monitor it carefully, and go back on medications if my health worsens. But in general, this is great news for the quality of my own life, as well as for my health-insurer. If further research confirms these findings, then the cost structure of HIV care could also be transformed – especially for those who do not have insurance. We don’t know for sure yet – and everyone’s body is different – but this strikes me as really good news, and worth a little cheer. The only downside is that people like me who were once undetectable and barely infectious are now more liable to transmit the disease, because of our modestly higher viral loads. If there’s a shift in the number of similarly more infectious people in the population, transmission could tick upward. All the more reason to practice safer sex, or to keep sexual contact within the HIV-positive population.
The Dish 