@pfizer @POTUS @TheDemocrats @VP @CNN @CBSNews @NBCNews @WKRN @WSMV @NC5 I have had the amazing opportunity to sit on Vanderbilt's HIV/AIDS Clinical Trials Community Advisory board since 2015 and want to shine a bright light on how therapeutics with SARS-Cov-2 should have been managed in the same way as HIV.
@pfizer @POTUS @TheDemocrats @VP @CNN @CBSNews @NBCNews @WKRN @WSMV @NC5 During the early years of the HIV/AIDS crisis, many were without any options. Then, AZT and other handfuls of medications were made available. Those who took it were literally guinea pigs. While supposition, I imagine escaping hospitalization and death were the metrics used.
@pfizer @POTUS @TheDemocrats @VP @CNN @CBSNews @NBCNews @WKRN @WSMV @NC5 As research advanced, more medications became available, including the protease inhibitor, the class to which Paxlovid belongs.
@pfizer @POTUS @TheDemocrats @VP @CNN @CBSNews @NBCNews @WKRN @WSMV @NC5 When the point of care viral load test was created, the management of those living with HIV changed beyond measure. It was at that time that drug manufacturers had a objective efficacy measurement.
@pfizer @POTUS @TheDemocrats @VP @CNN @CBSNews @NBCNews @WKRN @WSMV @NC5 Today, companies such as Gilead release virologic data with their medications. It reports log copy reduction, barrier to resistance information, and any reports of virologic failure.
@pfizer @POTUS @TheDemocrats @VP @CNN @CBSNews @NBCNews @WKRN @WSMV @NC5 The medical community and our federal government has allowed @Pfizer to return us to the pre viral load test days. To my knowledge they have yet to provide any data concerning log copy reductions, resistance data, and virologic failure data.
@pfizer @POTUS @TheDemocrats @VP @CNN @CBSNews @NBCNews @WKRN @WSMV @NC5 Interestingly, it has been the media that has reported the virologic failure with Paxlovid and have couched it in a much more palatable, less "scary" term called rebound.
@pfizer @POTUS @TheDemocrats @VP @CNN @CBSNews @NBCNews @WKRN @WSMV @NC5 As I mentioned above, Paxlovid is a protease inhibitor and I will now explain with John's help why it should not be considered a viable option.
@pfizer @POTUS @TheDemocrats @VP @CNN @CBSNews @NBCNews @WKRN @WSMV @NC5 One of the most disturbing physiological aberrations that Paxlovid can cause if used for an extended period of time is lipodystrophy, which is an abnormal redistribution of adipose, or fat, tissue.
@pfizer @POTUS @TheDemocrats @VP @CNN @CBSNews @NBCNews @WKRN @WSMV @NC5 Considering our obsession with social media and an ever growing vain society, this is particularly troubling. What does lipodystrophy look like? Let me show you and you decide if you want to experience it.
@pfizer @POTUS @TheDemocrats @VP @CNN @CBSNews @NBCNews @WKRN @WSMV @NC5 We have seen what the consequences of protease inhibitor is on appearance. What about other physiological processes? Glad you asked.
@pfizer @POTUS @TheDemocrats @VP @CNN @CBSNews @NBCNews @WKRN @WSMV @NC5 They can downregulate triglyceride synthesis, resulting in hypertriglyceridemia.

They can steatosis, or an abnormal fat accumulation, in the liver.

They can cause pancreatitis.

They can cause atherosclerosis, hardening of the arteries due to cholesterol.
@pfizer @POTUS @TheDemocrats @VP @CNN @CBSNews @NBCNews @WKRN @WSMV @NC5 They can cause Type 2 Diabetes

They can cause insulin resistance.

They can cause postprandial, after meal, glucose levels to be elevated leading to glucose intolerance.
@pfizer @POTUS @TheDemocrats @VP @CNN @CBSNews @NBCNews @WKRN @WSMV @NC5 It is important to note that the organs associated with the derangements mentioned are all rich in ACE-2 receptors and are more than likely damaged from the SARS-Cov-2 infection
@pfizer @POTUS @TheDemocrats @VP @CNN @CBSNews @NBCNews @WKRN @WSMV @NC5 There are a number of first line HIV medications that have proven to molecularly dock with SARS-Cov-2 and should be investigated. No, Pfizer does not make them.
@Pfizer CEO tested positive. Ask him if he will take it for an extended period of time.

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More from @dbdugger

Sep 18
An old feller wanted to take me out to woodshed concerning a post about organ donation. Here is an interesting article especially for those who are either awaiting an organ transplant or know someone that is.
The organ donor tested negative for SARS-Cov-2 via a nasopharyngeal PCR test, which is what is typically performed in a clinical setting. Testing for the presence of replication competent virus in the organs to be transplanted was performed.
During the operation, not only was the donor infected, so was a member of the transplant team. Transplantation of the diseased organs resulted in such an insult to the recipient that they unfortunately passed away.
Read 6 tweets
Sep 18
@echo_masters reached out concerning how one might be able to combat CD4 depletion. Shortly after joining Vanderbilt's HIV/AIDS Clinical Trials Group CAB, I read this article. ncbi.nlm.nih.gov/pmc/articles/P…
@echo_masters The paper relates to a study in Rwanda. The probiotic strain included in the yogurt was Lactobacillus rhamnosus GR-1.
@echo_masters What were the results? To put these increases in perspective, studies have estimated that ART increases the average annual CD4 count by 90 cells/µl versus an average decline of 20–50 cells/µl/year without treatment.
Read 4 tweets
Sep 17
Preprint worth reading! medrxiv.org/content/10.110…
"We favor the idea that increased CD8 cells may indeed indicate persistent infection, in line with current hypotheses on viral persistence as a potential causal factor in long Covid."
Naive CD4 lymphocytopenia @fitterhappierAJ
Read 6 tweets
Sep 5
@kathrynsbach @BillHanage @n_hold @zeynep @ballerina9999 @s_j_prins @wsbgnl Absolutely, it would be my pleasure. Several months ago, I had the occasion of talking with a client who complained of brain fog and I found this article.
@kathrynsbach @BillHanage @n_hold @zeynep @ballerina9999 @s_j_prins @wsbgnl Having studied a&p since 1996 and HIV since 2015, this article scared the literal hell out of me because of what it actually means, reservoir seeding.
@kathrynsbach @BillHanage @n_hold @zeynep @ballerina9999 @s_j_prins @wsbgnl There are two well known reservoirs in HIV. The first is the Central Nervous System and the second is the Gut Associated Lymphoid Tissues, which extend from the mouth to the anus.
Read 56 tweets
Sep 4
Ran across a journal article that I had printed months ago discussing HIV Associated Neurocognitive Decline. Within the possible therapeutics section there was a mention of intranasal administration of insulin.
Decided to pull the article that they relied upon for that suggestion. You can find it here. ncbi.nlm.nih.gov/pmc/articles/P…
Outcome measures were analyzed using repeated-measures analysis of covariance. Treatment with 20 IU of insulin improved delayed memory (P < .05), and both doses of insulin (20 and 40 IU) preserved caregiver-rated functional ability (P < .01).
Read 8 tweets
Aug 30
@ChristosArgyrop You are 100% correct. As I wrote yesterday, this is not our first rodeo with an unspecified pneumonia that cause lymphocytopenia and viral persistence.
@ChristosArgyrop We have ignored 40 years of research and literature. We do not have a durable antiviral. We do not have a point of care viral load/resistance panel.
@ChristosArgyrop What we do have is an estimated 14 million with PACS. 1.2 million are living with HIV. Ryan White annual budget is 2 BILLION. What will the PACS equivalent be?
Read 4 tweets

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