Thread by @dbdugger

Those who turned a blind eye to forty years of evidenced based medicine that allows 1.2 million to maintain their autonomy, immune competence, and cognition sure did make a big ol’ mess, didn’t they?

https://twitter.com/sun_in_winter12/status/1780015782853837310

That it would be prudent to borrow from HIV medicine was made known several years ago. On September 28th, 2020, it became known that SARS-Cov-2 depletes the CD4 compartment.
SARS-CoV-2 Uses CD4 to Infect T Helper Lymphocytes
medrxiv.org/content/10.110…

That this hallmark of a chronic HIV infection is observed in those living with a chronic SARS-Cov-2 infection was once again made known in March of 2022.
ACE2-independent infection of T lymphocytes by SARS-CoV-2
nature.com/articles/s4139…

Since September of 2022, Covid-19 has appeared directly under HIV on Merck Medical's website. merckmanuals.com/professional/h…

On September 29th, 2020, Kenneth Podell predicted those living with a chronic SARS-Cov-2 infection would live with the functional equivalent of HIV Associated Neurocognitive Decline. He was right. ncbi.nlm.nih.gov/pmc/articles/P…

Persistence has been known as early as when the first monoclonal was wiped out, as they cannot develop resistance on there on. Rather, it develops as a consequence of abrupt discontinuation of therapeutics in the presence of that which they mention, replication competent virus.

They mention the brain and GI tract. In December of 2021, Dr. Daniel Chertow implicated those very things, the Central Nervous System and Gut Associated Lymphoid Tissue reservoirs. SARS-CoV-2 infection and persistence throughout the human body and brain
assets.researchsquare.com/files/rs-11390…

The consequences of reservoir involvement in those living with HIV is well known. Once they are "seeded" antivirals are unable to sufficiently penetrate them to remove all of the replication competent virus, preventing a sterilizing cure.

HIV Persistence in Gut-Associated Lymphoid Tissues: Pharmacological Challenges and Opportunities ncbi.nlm.nih.gov/pmc/articles/P…

GALT is the largest component of the lymphoid system, comprising the tonsils, Peyer's patches, lymphoid aggregates in the stomach and small intestine, and lymphoid cells in the lamina propria.

GALT contains the highest concentration of CD4+ T cells, making it an ideal target for HIV infection.

A critical obstacle to achieving HIV eradication in GALT is the potential for inadequate ARV distribution into this compartment.

ARV penetration into gut tissues is highly variable, both between and within drug classes,51 and is not easily predicted based on chemical structure or standard pharmacokinetic properties.

Chertow and now the NIH director have shed light on why individuals now live with POTS and erectile dysfunction. GALT reservoir expansion, specifically the jejunum.

Symptoms of Autonomic Dysfunction in Human Immunodeficiency Virus ncbi.nlm.nih.gov/pmc/articles/P…

Pathologic studies involving the jejunal mucosa of HIV-positive patients demonstrates that damage to the autonomic nerve fibers occurs early in the course of HIV infection.

While Chertow did not implicate individual cell types within the Central Nervous System reservoir that are productively, others have. Every cell type that constitutes the CNS reservoir in those living with HIV is productively infected by SARS-Cov-2.

Both HIV and SARS-Cov-2 productively infect astrocytes. A1 phenotype involvement leads to glymphatic system disturbances. Along with microglia, they exert a "bystander" effect on oligodendrocytes, responsible for the production of myelin. ncbi.nlm.nih.gov/pmc/articles/P…

With both HIV and SARS-Cov-2, there is perivascular macrophage involvement. Like all other macrophages, they are resistant to apoptosis. The primary target of HIV, their relative quick turnover leads to the appearance and disappearance of virus within the CNS.

With both HIV and SARS-Cov-2, there is choroid plexus involvement, which is responsible for the production of cerebrospinal fluid and its dysregulation can lead to the development of ventriculomegaly. nature.com/articles/s4158…

Like this.
Maternal COVID-19 Infection and Possible Associated Adverse Neurological Fetal Outcomes, Two Case Reports pubmed.ncbi.nlm.nih.gov/34814196/

Both HIV and SARS-Cov-2 productively infect brain pericytes, known to harbor latent virus and contribute to not only Blood Brain Barrier degradation but Cerebral Blood Flow disturbances, as well.
pubmed.ncbi.nlm.nih.gov/34769052/

Those living with a chronic SARS-Cov-2 infection are experiencing the productive infection of the primary cell type that constitutes the CNS reservoir in those living with HIV, microglia.
pubmed.ncbi.nlm.nih.gov/35510852/

Among those cell types resistant to apoptosis, clearance will require a Latency Reversal Agent to "Shock & Kill" or Latency Promoting Agent to "Lock & Block. Neither strategy has proven effective for HIV, despite forty years of research.

With their dysregulation, there is a predisposition to Alzheimer's, Parkinson's, and Amyotrophic Lateral Sclerosis. Beyond microglia involvement, amyloid deposition, known since 2022, can lead to AD.

In addition to microglia involvement, basal ganglia persistence, to which the substantia nigra belongs, observe by Chertow in December of 2021, can lead to Parkinson's disease.

Every single day that parallels are drawn to ME/CFS, significant neurological and immunological harm is inflicted upon millions, with that harm being reported in the news.

In those individuals experiencing immune system dysregulation, including depletion of the CD4 compartment, there is but a short period of time in which to initiate antivirals, one year from the Estimated Date of Seroconversion.

Rapid initiation of antivirals prevents against profound reservoir seeding, allows for CD4 normalization (returning to pre-infection levels), and preserves a CD4 nadir that guards against neuropsychiatric complications and opportunistic infections.

Had individuals listened to Kenneth Podell, they would have familiarized themselves with the Frascati Criteria, used to "stage" the neurocognitive impairment of those living with HIV.

The Frascati Criteria recognizes three stages of impairment. That of Asymptomatic Neurocognitive Impairment, Mild Neurocognitive Decline, and AIDS Dementia Complex.

At least two studies have relied upon the Frascati Criteria, including the work of Dr. Apple. ucsf.edu/news/2022/01/4…

All participants underwent an in-person cognitive testing battery with a neuropsychologist, applying equivalent criteria used for HIV-associated neurocognitive disorder (HAND).

Surprisingly, the researchers found that 13 of the 22 participants (59 percent) with cognitive symptoms met HAND criteria, compared with seven of the 10 control participants (70 percent).

Unlike those diagnosed with ME/CFS, seventy percent of her control arm were not complaining of cognitive impairment, despite the fact they were. They have been left to experience further disease progression.

Those diagnosed with ANI face a two to six times increased risk of further disease progression, with Mild Neurocognitive Decline coming next. ncbi.nlm.nih.gov/pmc/articles/P…

Conversion from asymptomatic to symptomatic HAND
Despite being asymptomatic, ANI is clinically relevant because individuals with ANI can transition to one of the more severe forms of HAND.

For example, participants of the CNS HIV Antiretroviral Therapy Effects Research (CHARTER) study who had ANI at baseline were two to six times more likely to develop symptomatic HAND during several years of follow-up than those who were neurocognitively normal at baseline

This study also relied upon the Frascati Criteria and highlights the consequences of turning a blind eye to the concept of the CD4 nadir, or lowest CD4 count.

Reduced Cortical Thickness Correlates of Cognitive Dysfunction in Post-COVID-19 Condition: Insights from a Long-Term Follow-up ajnr.org/content/early/…