A (t) Indeed we think
that it is useful to use so-called complementary treatments,
either for patients with or without an official
antiretroviral treatment.
Among these treatments,
some appear essential to use. Vimanin C (at least 750 mg a
day, in tablets or fruits; kiwi is the fruit that contains
the most), glucuronamide (Guronsan®, 1 tablet in the
morning, or Detoxalgine®, 2 tablet in the morning; these
two compounds bring 500 mg vitamin C), vitamin E (Toco
500®, 2 to 3 tablets a day, reimbursed) and Selenium (2
vials in the morning, reimbursed). Some of these treatments
(vitamin C and E) are even officially recommended by
"official" associations, such as Aides (in its newspaper,
Remaides).
Other so-called
complementary treatments may have an interest, as more and
more researchers consider that HIV is not sufficient to
explain the evolution of the infection to AIDS. Cofactors
would intervene, maybe in a different manner with the
patients (the state of oxidation of the cells is one of the
co-factors on which vitamins C and E act).
But, for several among
these treatments, further studies should be carried out to
confirm or not their interest.
If you could connect to
our Internet website <http://www.positifs.org/>, you
could have numerous informations on these treatments (this
site proposes more than 500 pages of informations, more than
half concerning treatments).
Concerning official
antiretroviral treatments, they shouldn't be started too
soon, neither too late.
New recommandations have
been published by international experts in June 1997. A
consensus exists, about the idea of treating "soon and
strong". But opinions are differing concerning biological
values to retain as limit points.
Bitherapies (AZT-ddI,
AZT-ddC, AZT-3TC) must'nt be used any longer, as their may
provoke resistances, making later tritherapies less
efficient.
A tritherapy is now
officially recommended in case of clinical signs
(opportunistic infection), at any level of CD4 cell count
and viral load. Same case, even with a satisfying viral
load, if CD4 cells are inferior to 200/mm3, and for more
specialists, inferior to 350/mm3, even to 500/mm3. Same case
with high count of CD4 cell, if the viral load is superior
to 30- 50,000 copies/ml, even for certains specialists,
superior to 10,000 or 5,000 copies.
For non treated patients,
viral load should be checked every 3 to 6 months.
D4T-3TC-Indinavir
association, one of the most interesting tritherapies, in
terms of efficiency, should be used in first
intention.
The ideal is to reach,
with a tritherapy, an undetectable viral load in 6 months,
and if possible in 3 months. In case of reapparition of a
detectable viral load, this result must imperatively
confirmed 15 days after, and lead to a replacement of at
least two of the three molecules, if possible. A viral load
that would remain superior to 1,000 copies/ml three months
after the beginning of a tritherapy would be the sign of a
rebound.
We hope that our mail will
help you to understand more clearly the domain of official
antiretroviral treatments, as well as complementary
treatments.
* Concerning official
treatments, Bactrim treatment (1 tablet a day) prevents from
pulmonary pneumocystosis or cerebral toxoplasmosis, two of
the most frequent opportunistic infections. This primary
prevention is advised for people with less than 200 CD4
cells/mm3, or under 15% (in case of allergy,
desensibilisation techniques may be used). In some cases,
other prophylaxies are also advised (particularly concerning
mycobacteria).
(9712)
